SAVE THE DATES! - Seacoast Cancer 5K

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SAVE THE DATES! - Seacoast Cancer 5K
SAVE THE DATES!
                                                       September 18-25, 2021 Virtual 5K
                                                       September 25, 2021 Community Celebration
                                                       September 26, 2021 In-person 5K

SPONSORSHIP OPPORTUNITIES

We invite you to join us in celebrating the 8th        We hope we can count on you to make an impact
Annual Seacoast Cancer 5K to make a difference for     this year. Sign up today to join our efforts to
patients and families impacted by cancer throughout    provide cutting edge, compassionate cancer
the Seacoast. This year, participants have a choice    care to patients, survivors and their loved ones at
of joining us in person on Sunday, September 26,       Wentworth-Douglass Hospital’s Seacoast Cancer
2021 at Wentworth-Douglass Hospital, or virtually      Center. Learn more at SeacoastCancer5K.org.
between September 18-25, 2021.

Since its inception, the Seacoast Cancer 5K has
raised more than $1.5 million and has quickly grown
into one of the largest fundraisers on the Seacoast.
This year is no different with a goal of 3,000
participants and $500,000 to benefit programs and
services provided at the Seacoast Cancer Center.
Our sponsors are the driving force behind the
success of this event!                                                                             1
SAVE THE DATES! - Seacoast Cancer 5K
2020 FACTS AT A                       GLA N C E

                                                                 1,140
                                                                 Registered
     $260,584
                                                                 8% Over age 65
           Funds raised
                                                                 30% Ages 50-64
                                                                 19% Ages 40-49
           $1.8M                                                 20% Ages 30-39
                                                                 13% Ages 18-29
     Cumulative funds raised                                     10% Under age 18

Social Media
   16,000+                             31%
                                       MALE
                                                      69%
                                                     FEMALE
                                                                         78
            WDH followers                                                Survivors

      1,834+
      5K followers

            5,049
            Seacoast Cancer Center
            patients impacted
                                              16
                                              States             7
           13,134                             represented
                                                                 Participants
                                                                 in Europe
           E-mail subscribers

                                              Supporting cancer survivors in the

  975          7 Countries 32 States          Seacoast community since 2014!
                                                 SeacoastCancer5K.org
  Donors       268 Cities and Towns                                         2
SAVE THE DATES! - Seacoast Cancer 5K
September 18-25, 2021 Virtual 5K                            September 26, 2021 In-person 5K
ANYTIME, ANYWHERE                                           Wentworth-Douglass Hospital | 9:00am

                                                                          -certified Route #NH18009BK
  A RunSignUp Product

Download our RaceJoy app to choose                                    Free parking onsite!
your 5K route.

              For all Crusaders!                                      For all Crusaders!

                            REGISTRATION FEE: Champion: $25 (Bib only) | Crusader: $35 (Bib + Shirt)
                                     Learn more and register online at SeacoastCancer5K.org

September 25, 2021 Community Celebration
Wentworth-Douglass Hospital | $10 per ticket
                                                                            Stay Informed
                                                   Special Guest
              Live Music                           NBC Sports               Follow us on social media or
                                                   Boston                   visit SeacoastCancer5K.org
                                                   Celtics color            for the latest event details.
              Food Trucks                          analyst Brian
                                                   Scalabrine!

              Activities
              & Games

                        SeacoastCancer5K.org | (603) 740-2687 | specialevents@wdhospital.org
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SAVE THE DATES! - Seacoast Cancer 5K
LEGEND:
                                                                                                                * In-person only
                                                                                                                   ^ Virtual only

TITLE SPONSOR (EXCLUSIVE)                                                                                                $25,000

A unique, exclusive opportunity for joint co-branding of one of the largest fundraisers on the Seacoast, with a specially
designed logo on all event marketing and promotional materials, website and electronic outreach. Features two high-
visibility speaking opportunities for company leadership, as listed below, plus the following sponsorship benefits:
•    Private tour of the Seacoast Cancer Center with             •       *Speaking opportunity at exclusive pre-race VIP Breakfast
     SCC leadership (per WDH visitor guidelines)                         with Brian Scalabrine, WDH leadership & top
•    Year-round invitations to WDH Foundation events                     sponsors/fundraisers
•    VIP experience with 5K Ambassador and NBC Sports            •       *Opportunity to hold finish line ribbon for top finisher
     Boston Celtics Color Analyst, Brian Scalabrine              •       Co-branded event logo listed on event materials including
•    25 complimentary admissions to the Community                        promotional, marketing, website and email collateral
     Celebration                                                 •       Co-branded event logo on official 5K shirts
•    25 complimentary 5K event registrations                     •       *DJ announcements during Community Celebration and 5K
•    *Speaking opportunity at the start of the In-Person 5K to
     address the large crowd of participants

FINISH LINE SPONSOR (EXCLUSIVE)              NEW                                                                         $20,000

An exclusive opportunity with extremely high visibility to have your company’s logo on the painted
2021 5K finish line located on Old Rollinsford Road. Your company’s logo will be seen by visitors to
Wentworth-Douglass Hospital and other medical practices year-round and remind them of your
incredible support of the Seacoast Cancer 5K. Sponsorship also provides:
•    Private tour of the Seacoast Cancer Center with SCC             •    20 complimentary admissions
     leadership (per WDH visitor guidelines)                              to the Community Celebration
•    Year-round invitations to WDH Foundation events                 •    20 complimentary 5K event
•    Invitation to exclusive 2021 finish line rededication                registrations
•    VIP experience with 5K Ambassador and NBC Sports                •    *Invitation to exclusive pre-race
     Boston Celtics Color Analyst, Brian Scalabrine                       VIP Breakfast with Brian
•    Opportunity to address the crowd at the start/finish                 Scalabrine, WDH leadership & top sponsors/fundraisers
     line during the 5K                                              •    Logo listed on event materials including promotional,
                                                                          marketing, website and email collateral
                                                   Your logo
                                                                     •    Logo on official 5K shirts
                                                     here!
                                                                     •    *DJ announcements during the 5K

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SAVE THE DATES! - Seacoast Cancer 5K
FESTIVAL SITE SPONSOR (EXCLUSIVE)           NEW                                                                     $20,000

A highly visible opportunity for your company to be the exclusive sponsor of the South Parking Lot, where the Seacoast
Cancer 5K Festival Site is located. This is the hub of all the action: Saturday’s Community Celebration, bib pick-up, sponsor
tents, food and drink, the awards ceremony, live entertainment and more! Your company’s name & logo will be featured as
the sponsor of the festival site on Saturday and Sunday. Your company’s logo will be prominently featured on the large
archway at the entrance to the festival site. Sponsorship also provides:
 •   Private tour of the Seacoast Cancer Center with SCC       •   *Invitation to exclusive pre-race VIP Breakfast with Brian
     leadership                                                    Scalabrine, WDH leadership & top sponsors/fundraisers
 •   Year-round invitations to WDH Foundation events           •   Opportunity to address the crowd at the 5K
 •   VIP experience with 5K Ambassador and NBC Sports          •   Logo listed on event materials including promotional,
     Boston Celtics Color Analyst, Brian Scalabrine                marketing, website and email collateral
 •   20 complimentary admissions to the Community              •   Logo on official 5K shirts
     Celebration                                               •   *DJ announcements during the 5K
 •   20 complimentary 5K event registrations

                                                  NEW
BIG SCREEN SPONSOR (EXCLUSIVE)                                                                                      $15,000

A highly visible opportunity to brand the 5K “big screen” with your company’s logo. Feature
your logo on banners on both sides of the screen and one below, on the base of the trailer. The
screen will be located at three events: the 5K Express event on Friday, September 17th; the
Community Celebration on Saturday, September 25th, and the 5K Road Race on Sunday,
September 26th. Sponsorship also provides:

 •   *Invitation to exclusive pre-race VIP Breakfast with      •   Logo listed on event
     Brian Scalabrine, WDH leadership & top                        materials including
     sponsors/fundraisers                                          promotional, marketing,
 •   15 complimentary admissions to the Community                  website and email collateral
     Celebration                                               •   Logo on official 5K shirts
 •   15 complimentary 5K event registrations                   •   *DJ announcements during the 5K
 •   *Opportunity to address the crowd Saturday and
     Sunday

AWARDS CEREMONY SPONSOR (EXCLUSIVE)                                                                                 $10,000

An opportunity to feature your company’s name & logo as the official sponsor of the Awards Ceremony on the main stage
on Sunday, which will also be streamed on social media for virtual participants. Sponsorship provides a speaking
opportunity on the main stage for your company’s representative during the Awards Ceremony. Sponsorship also provides:
 •   *Invitation to exclusive pre-race VIP Breakfast with      •   Opportunity to address the crowd at the 5K
     Brian Scalabrine, WDH leadership & top                    •   Logo listed on event materials including promotional,
     sponsors/fundraisers                                          marketing, website and email collateral
 •   15 complimentary admissions to the Community              •   Logo on official 5K shirts
     Celebration                                               •   *DJ announcements during the 5K
 •   15 complimentary 5K event registrations

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SAVE THE DATES! - Seacoast Cancer 5K
COMMUNITY CELEBRATION SPONSOR (EXCLUSIVE)                     NEW                                                 $10,000

An exciting opportunity to be the exclusive sponsor of the brand-new family-friendly Community Celebration on
September 25th in the WDH South Parking Lot. Attendees will enjoy live music, a Beer Garden, food trucks, a Kids Zone, plus
special guest 5K Ambassador and NBC Sports Boston Celtics Color Analyst, Brian Scalabrine! Sponsorship also provides:

 •   VIP experience with Brian Scalabrine                         •    15 complimentary 5K event registrations
 •   *Invitation to exclusive pre-race VIP Breakfast with         •    Opportunity to speak from main stage on Saturday
     Brian Scalabrine, WDH leadership & top                       •    Logo listed on event materials including
     sponsors/fundraisers                                              promotional, marketing, website and email collateral
 •   15 complimentary admissions to the Community                 •    Logo on official 5K shirts
     Celebration                                                  •    *DJ announcements on Saturday

START LINE SPONSOR (2 OPPORTUNITIES) 1 SOLD                                                                         $10,000

Your company’s logo will be featured on the two pillars prominently displayed at the start line area where a crowd will
gather to race on Sunday. Your logo will also be featured on the start line stage. Sponsorship also provides:
 •   *Invitation to exclusive pre-race VIP Breakfast with         •    10 complimentary 5K event registrations
     Brian Scalabrine, WDH leadership & top                       •    Logo listed on event materials including
     sponsors/fundraisers                                              promotional, marketing, website and email collateral
 •   Logo on official 5K shirts                                   •    *DJ announcements during the 5K
 •   10 complimentary admissions to the Community
     Celebration

BIB SPONSOR (EXCLUSIVE)                                                                                             $10,000

Your company’s logo will be prominently displayed on the official race bib worn by 3,000+ race participants, including on
all bibs sent to virtual participants and coloring bibs for children. Sponsorship also provides:
 •   *Invitation to exclusive pre-race VIP Breakfast with          •   10 complimentary 5K event registrations
     Brian Scalabrine, WDH leadership & top                        •   Logo listed on event materials including
     sponsors/fundraisers                                              promotional, marketing, website and email collateral
 •   Logo on official 5K shirts                                    •   *DJ announcements during the 5K
 •   10 complimentary admissions to the Community
     Celebration

HYDRATION SPONSOR (EXCLUSIVE)                                                                                       $7,500

Your company’s logo will be featured on bottles of water distributed to all participants, spectators and volunteers at the 5K
road race on Sunday. Sponsorship also provides:
 •   *Invitation to exclusive pre-race VIP Breakfast with          •   5 complimentary 5K event registrations
     Brian Scalabrine, WDH leadership & top                        •   Logo listed on event materials including
     sponsors/fundraisers                                              promotional, marketing, website and email collateral
 •   Logo on official 5K shirts                                    •   *DJ announcements during the 5K
 •   5 complimentary admissions to the Community
     Celebration

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SAVE THE DATES! - Seacoast Cancer 5K
RACE SHIRT SPONSOR (2 OPPORTUNITIES) 1 SOLD                                                                          $7,500

Your company’s logo will be featured prominently on the official race shirt for the 5K. Sponsorship also provides:
     *Invitation to exclusive pre-race VIP Breakfast with          • 5 complimentary 5K event registrations
                                                                   THANK YOU TO OUR 2020 SPONSORS
 •
     Brian Scalabrine, WDH leadership & top                        • Logo listed on event materials including
     sponsors/fundraisers                                            promotional, marketing, website and email collateral
 •   5 complimentary admissions to the Community                   • *DJ announcements during the 5K
     Celebration

PHOTO SPONSOR (EXCLUSIVE)                                                                                            $7,500

Your company’s logo will be featured on the race photography captured along the route on Sunday and provided
complimentary to all Seacoast Cancer 5K participants via social media and email. Your logo will also be featured on all
photos uploaded by participants through RunSignUp. Sponsorship also provides:
 •   *Invitation to exclusive pre-race VIP Breakfast with          •    5 complimentary 5K event registrations
     Brian Scalabrine, WDH leadership & top                        •    Logo listed on event materials including
     sponsors/fundraisers                                               promotional, marketing, website and email collateral
 •   Logo on official 5K shirts                                    •    *DJ announcements during the 5K
 •   5 complimentary admissions to the Community
     Celebration

MAIN STAGE SPONSOR (5 OPPORTUNITIES) 2 SOLD                                                                          $7,500

Your company’s logo will be featured on two large banners displayed on the main
stage at the Festival Site that hosts the Community Celebration and Sunday’s pre-
event warm-up and post-event Awards Ceremony. Sponsorship also provides:
 •   *Invitation to exclusive pre-race VIP Breakfast with          •    Logo listed
     Brian Scalabrine, WDH leadership & top                             on event
     sponsors/fundraisers                                               materials
 •   Logo on official 5K shirts                                         including
 •   5 complimentary admissions to the Community                        promotional,
     Celebration                                                        marketing, website and email collateral
 •   5 complimentary 5K event registrations                        •    *DJ announcements during the 5K

KID ZONE SPONSOR (EXCLUSIVE)                                                                                         $6,000

Feature your company’s logo at the Kid Zone area located in the center of Festival Site during the Community Celebration
and In-person 5K. Your logo will also be featured on children’s coloring pages, word searches, art projects and “Flat Scal”
on the 5K website. Sponsorship also provides:
 •   Logo on kids race ribbons                                      •   5 complimentary 5K event registrations
 •   *Invitation to exclusive pre-race VIP Breakfast with           •   Logo listed on event materials including
     Brian Scalabrine, WDH leadership & top                             promotional, marketing, website and email
     sponsors/fundraisers                                               collateral
 •   Logo on official 5K shirts                                     •   *DJ announcements during the 5K
 •   5 complimentary admissions to the Community
     Celebration

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SAVE THE DATES! - Seacoast Cancer 5K
FOOD COURT SPONSOR (3 OPPORTUNITIES) 2 SOLD                                                                        $5,000

Your company’s logo will be featured at the Food Court area located in the center of the Festival Site where all In-person
5K participants receive complimentary snacks and beverages. Sponsorship also provides:
 •   *Invitation to exclusive pre-race VIP Breakfast with          •THANK      YOU TO
                                                                      5 complimentary      OUR
                                                                                      5K event      2020 SPONSORS
                                                                                               registrations
     Brian Scalabrine, WDH leadership & top                        • Logo listed on event materials including
     sponsors/fundraisers                                             promotional, marketing, website and email collateral
 •   Logo on official 5K shirts                                    • *DJ announcements during the 5K
 •   5 complimentary admissions to the Community
     Celebration

                                                 NEW
ONLINE AUCTION SPONSOR (EXCLUSIVE)                                                                                 $5,000

Your company’s name & logo will be featured as the exclusive sponsor of our online auction that runs from September 12-
26, 2021. Your name and logo will be featured on all auction collateral and announcements. Sponsorship also provides:
 •   *Invitation to exclusive pre-race VIP Breakfast with          •   5 complimentary 5K event registrations
     Brian Scalabrine, WDH leadership & top                        •   Logo listed on event materials including
     sponsors/fundraisers                                              promotional, marketing, website and email collateral
 •   Logo on official 5K shirts                                    •   *DJ announcements during the 5K
 •   5 complimentary admissions to the Community
     Celebration

VOLUNTEER SPONSOR (EXCLUSIVE)                                                                                      $5,000

Feature your company’s logo on lanyards worn by all volunteers and event staff throughout all 5K events, on giveaway
bags provided to event volunteers, and at the Volunteer Tent located at the Festival Site. Sponsorship also provides:
 •   *Invitation to exclusive pre-race VIP Breakfast with          •   5 complimentary 5K event registrations
     Brian Scalabrine, WDH leadership & top                        •   Logo listed on event materials including
     sponsors/fundraisers                                              promotional, marketing, website and email collateral
 •   Logo on official 5K shirts                                    •   Logo listed on volunteer email blasts
 •   5 complimentary admissions to the Community                   •   *DJ announcements during the 5K
     Celebration

VIP BREAKFAST SPONSOR (EXCLUSIVE)                                                                                  $4,000

Your company’s logo will be featured as the exclusive sponsor of Sunday’s 5K pre-event VIP Breakfast where fellow
sponsors, WDH leadership and top fundraisers will be in attendance. Sponsorship also provides:
 •   *Invitation to exclusive pre-race VIP Breakfast with          •   4 complimentary admissions to the Community
     Brian Scalabrine, WDH leadership & top                            Celebration
     sponsors/fundraisers                                          •   Logo listed on event materials including
 •   Logo on official 5K shirts                                        promotional, marketing, website and email collateral
                                                                   •   4 complimentary 5K event registrations

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SAVE THE DATES! - Seacoast Cancer 5K
CELEBRATION SPONSOR (UNLIMITED) 2 SOLD                                                                                 $3,000

Feature your company’s logo on a customized tear drop banner located along the In-person
5K course. Sponsorship also provides:
 •   *Invitation to exclusive pre-race VIP Breakfast with     •       Logo listed on event
     Brian Scalabrine, WDH leadership & top                           materials including
     sponsors/fundraisers                                             promotional, marketing,
 •   Logo on official 5K shirts                                       website and email collateral
 •   3 complimentary admissions to the Community              •       3 complimentary 5K event
     Celebration                                                      registrations

                                              NEW                                                                      $3,000
5K ROCKSTARS SPONSOR (EXCLUSIVE)

5K Rockstars are our group of top fundraisers. Feature your company’s logo on the official 5K Rockstars t-shirts, trophy
packaging, and hospitality tent at the 5K Festival Site, plus in all 5K communication regarding 5K Rockstars. Sponsorship
also provides:
 •   *Invitation to exclusive pre-race VIP Breakfast with         •       Call-out during Awards Ceremony
     Brian Scalabrine, WDH leadership & top                       •       Logo listed on event materials including promotional,
     sponsors/fundraisers                                                 marketing, website and email collateral
 •   Logo on official 5K shirts                                   •       3 complimentary 5K event registrations
 •   3 complimentary admissions to the Community
     Celebration

5K EXPRESS SPONSOR (5 OPPORTUNITIES) 1 SOLD                                                                            $2,500

Feature your company’s logo on signs at the 5K Express t-shirt pick-up event on Friday, September 17th. Sponsorship also
provides:
 •   *Invitation to exclusive pre-race VIP Breakfast with             •    Name listed on event materials including
     Brian Scalabrine, WDH leadership & top                                promotional, marketing, website and email collateral
     sponsors/fundraisers                                             •    2 complimentary 5K event registrations
 •   Name listed on official 5K shirts

CHEER ZONE SPONSOR (6 OPPORTUNITIES) 1 SOLD                                                                            $2,500

Feature your company’s logo at a Cheer Zone location along the Seacoast Cancer 5K course. Sponsorship also provides:
 •   *Invitation to exclusive pre-race VIP Breakfast with             •     Name listed on event materials including
     Brian Scalabrine, WDH leadership & top                                 promotional, marketing, website and email collateral
     sponsors/fundraisers                                             •     2 complimentary 5K event registrations
 •   Name listed on official 5K shirts

WATER STOP SPONSOR (6 OPPORTUNITIES) 1 SOLD                                                                            $2,500

Feature your company’s logo at a Water Stop location along the Seacoast Cancer 5K course. Sponsorship also will provide:
 •   *Invitation to exclusive pre-race VIP Breakfast with             •     Name listed on event materials including
     Brian Scalabrine, WDH leadership & top                                 promotional, marketing, website and email collateral
     sponsors/fundraisers                                             •     2 complimentary 5K event registrations
 •   Name listed on official 5K shirts
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SAVE THE DATES! - Seacoast Cancer 5K
COURSE SPONSOR (EXCLUSIVE)                                                                                           $1,500

Your company’s name featured on all 6 Certified Course Routes through the Race Joy App. Sponsorship also provides:
 •   Invitation to exclusive pre-race VIP Breakfast with            •   Name listed on event materials including
     Brian Scalabrine, WDH leadership & top                             promotional, marketing, website and email
     sponsors/fundraisers                                               collateral
 •   Name listed on official 5K shirts                              •   2 complimentary 5K event registrations
 •   ^Virtual call-out during the sponsored courses

INSPIRATION WALL SPONSOR (UNLIMITED) 3 SOLD                                                                 $1,000 - $2,500

Feature your company’s name or logo on the banners that hang from the barricades lining the start/finish line of the 5K
race where runners and walkers pass through. The banners will include survivor names plus Seacoast Cancer Center facts
and will be visible on both Saturday and Sunday. Sponsorship also provides:
 •    $2,500 Level
            • *Logo of your company included on banner
            • Name listed on official 5K shirts, event materials including promotional, marketing, website and email
                collateral
            • 2 complimentary 5K event registrations
            • *Invitation to exclusive pre-race VIP Breakfast with Brian Scalabrine, WDH leadership &
                sponsors/fundraisers
 •    $1,000 Level
            • *Name of your company included on banner
            • Name listed on official 5K shirts, event materials including promotional, marketing, website and email
                collateral
            • 1 complimentary 5K event registration

CORPORATE PARTNERS (UNLIMITED) 3 SOLD                                                                                $500

Company name listed on event materials including promotional and marketing materials, as well as the event website and
email communications. You will receive one complimentary registration for the 5K.

IN ADDITION TO THE BENEFITS ASSOCIATED WITH THE SPECIFIC OPPORTUNITIES ABOVE, ALL SPONSORS RECEIVE:
    • Social media mentions to 16,000+ followers across multiple channels
    • Recognition in 2021 Wentworth-Douglass Foundation Annual Report mailed to 125,000+ households
    • *Exhibit space at the Seacoast Cancer 5K
    • Placement of sponsor-provided logoed items in giveaway bags

We are so grateful for donations of all amounts in support of our Seacoast Cancer 5K and happy to recognize companies that
provide a donation in the category below:

FRIENDS (UNLIMITED)        3 SOLD                                                                                   $250

Company name listed the event website.

                           *Wentworth-Douglass Hospital Foundation reserves the right to change sponsorship categories and benefits.

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TITLE SPONSOR              VIP BREAKFAST SPONSOR

     BIB SPONSOR                CELEBRATION SPONSORS

                                5K ROCKSTARS SPONSOR
 START LINE SPONSORS

                                 5K EXPRESS SPONSORS
 RACE SHIRT SPONSORS              Demoulas Foundation

                                CHEER ZONE SPONSORS
                                       Sodexo

                                WATER STOP SPONSORS
 MAIN STAGE SPONSORS
                                Sulloway & Hollis, P.L.L.C.

                                    COURSE SPONSOR
                         Northeast Rehabilitation Hospital Network
 FOOD COURT SPONSORS
                             INSPIRATION WALL SPONSORS
                                  New England Life Care
                                     Relyco Sales, Inc.
                              Wild Willy’s Burgers – Rochester
ONLINE AUCTION SPONSOR
                                 CORPORATE PARTNERS
                                Rochester Motorsports Inc.
                                    Snow Squall, LLC
                                      Stewart Title

                                  FRIENDS SPONSORS
  VOLUNTEER SPONSOR
                                 Dupont’s Service Center
                               Edward Jones – Nick Pellman
                                 National P.I. Services, LLC

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Thank you for your commitment to the Wentworth-Douglass Foundation to sponsor and support the 2021 Seacoast Cancer 5K.
This commitment will be utilized by Wentworth-Douglass Hospital to support and enhance programs and services benefiting
the Seacoast Cancer Center patients, families and caregivers. Your commitment and partnership are greatly appreciated!

SPONSORSHIP INFORMATION

(Sponsoring Organization)                         ___________hereby commits the amount of $ ___________
to the Wentworth-Douglass Foundation to enroll as a                  _______________ (sponsorship category).
Sponsoring Organization will receive visibility and recognition as part of the promotion and event dates of all
facets of the Seacoast Cancer 5K as detailed in the corresponding Seacoast Cancer 5K sponsorship category.

CONTACT INFORMATION

Sponsoring Organization (as it should be listed)
Contact Name____________________________ Title/Position ______________________________________
Address                                          City                   State     Zip    ____
Phone                                  Email                      Website         ____________

PAYMENT INFORMATION

            Check enclosed $                     (payable to: Wentworth-Douglass Foundation)

            Please send an invoice for $                    . Must be paid in full by September 15, 2021.
            Pay by credit card: Visit www.SeacoastCancer5K.org or contact Sarah Kuhl at (603) 609-6678.

                               Thank you for your support!

      Wentworth-Douglass Foundation is a 501(c)(3) charitable organization. Tax Identification Number: 51-0491062

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