Virtual Fundraiser Sign-up School/Team/Organization * Authorized Representative Name * First Name Last Name Title/Role * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Email * Purpose of Fundraiser * Target Amount $ Desired Start Date * MM DD YYYY Estimated Number of Participants * Authorized Representative Declaration * I understand that by checking this box I am indicating that I am authorized to act on behalf of the above named entity and that false representation is punishable by law. Yes, I am authorized No, I am not authorized Thank you for choosing The Bath Place Gives. You will be contacted within 24hrs.
