Please fill out all of the requested information below:

Contact Name & Title:
Organization:
Mailing Address:
City:	State:   ZIP:
E-mail:	Phone ##:
Date of Event:	Event Name:
Location of Event:
Anticipated Attendance:	Estimated contribution to Boggy Creek: $
Event Promotional Plan:
Brief details of proposed event/fundraisers:
Requested materials from Boggy Creek:
Promotional Video   Brochures   Door Prize/Auction Item
Plans to present funds:
Pleaste Note: An accounting of the event/promotion should be mailed/presented to Camp Boggy Creek within two weeks after event
Please describe any special requirements you are requesting of Camp boggy Creek, its facilities or staff: