Whales Lacrosse Charity-Tournament Pledge Form

By completing this form you agree to pay the amount indicated per goal made by the Whales Lacrosse teams* during the Oregon Lacrosse Classic in Bend, Oregon on July 22-24, 2016. Whales estimates the two teams will score a combined total of 60-100 goals and, regardless of actual goals scored, will cap “per-goal” pledges at 100 goals. To pledge per goal please complete the pledge donor form below. All pledges are tax deductible and will be processed by the Leukemia & Lymphoma Society within 10 business days of the event and receipts put in the mail to the address you list below.

Donor First Name: *

Donor Last Name: *

Pledge amount per goal amount:

(Per goal pledges will not be charged over 100 goals unless otherwise indicated)

*

Card Number (Visa, MC, Amex): *

Expiration Date *

CVC: *

Billing Address: *

City: *

State: *

Zip Code: *

Phone *

Email: *

Please list a player's name you are supporting or how you learned of this opportunity: *

Comments or messages for the team, Liz, or the player you know:

Thank you for supporting Whales Lacrosse Charity Tournament

and the Leukemia & Lymphoma Society!

*Whales Lacrosse team for this tournament consists of one middle school team and one high school team.