KidActive! Sponsorship Form

Please use this form to make a donation in memorial or as a tribute to a special person. Paddler Co-op will send a letter to the family you specify below to acknowledge your generous contribution. Sponsorship will provide you with a receipt of donation as well as a KidActive t-shirt. Please make cheque payable to Paddler Co-op. If you would like to download a PDF and fax it to us, you can get it here.


Type of Contribution*

 Personal
Business
In memory of:

On behalf of:

Your Name*

Organization

Street Address*

City/Town*

Province*

Postal Code*

Daytime Phone*

Email*

Evening Phone

Fax

Amount being sponsored:*

Donation Type*

 Cash
Cheque
Visa
Mastercard
Credit Card Number

Expiry Month

Expiry Year

Name of Child
Please complete the following only if you wish to sponsor a specific child in the KidActive program.
Name of Child

Age

Child's Street Address

Child's City/Town

Child's Province

Child's Postal Code

Child's Email

Child's Daytime Phone

Child's Evening Phone

Relationship to child/youth

Any additional information, including reasons for sponsorship:

Form Subject

* Required field
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