First Name
Last Name
Phone Number
E-Mail *
Street:
Town:
Postal Code:
I understand that I am making a commitment to 100 Men Who Give A Damn! - Vernon to make an annual donation of $400 ($100 at each of four meetings per year), which will be given directly to a local charity or one of its valuable programs that serves the Vernon community. *
I agree to fulfill my donation commitment even if I did not vote for the charity selected by majority vote.
I consent to my information being stored in the Vernons100Men.com database. I understand that this information will not be sold, given, or otherwise shared with a third party without my express consent unless required by law.
I acknowledge that there will be videographers/photographers present at 100 Men Who Give A Damn! – Vernon events. I understand that I may be included in a photo/video with or without my direct consent and grant permission ex gratia. I acknowledge that these photos and videos may be used on the internet and other public settings, strictly for educational purposes and to help spread the word about this incredible non-organization.
5 + 1 = ? Please prove that you are human by solving the equation *
