Please provide your contact and payment information. The contact information is required to generate a tax receipt. The electronic tax receipt will be sent to the email address that you provide.
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Survey Questions
How did you hear about the LIVERight Gala?
Do you have preferred seating?
If yes, please indicate the name/s of who you wish to sit with:
Please provide the name of your guest/s.
Please indicate any Dietary Restriction.
* I am a/an …
* In accepting this waiver, I (we) acknowledge that I (we) understand the intent thereof, and I (we) hereby agree and absolve and hold harmless the Canadian Liver Foundation, corporate sponsors, cooperating organizations and any other parties connected with this event in any way, singly or collectively, from and against any blame of liability for injury, misadventure, harm, loss, inconvenience or damage hereby sustained as a result of participation in this event or any activities associated herewith. I (we) hereby consent to and permit emergency treatment in the event of injury or illness. I (we) also give full permission for use of my (our) name and photograph in connection with this event.
Matching Gift
Your employer may match your gift. Enter your employer name below to see if your company offers matching gift.
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Company:
Subsidiary Of:
Foundation #:
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Contact:
Phone:
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Matching Gift Form URL:
Matching Gift Guidelines URL:
Minimum Amount Matched:
Maximum Amount Matched:
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Procedure:
If this is your employer, click on the button below
By continuing, you acknowledge that your credit card will be charged on a recurring basis for the duration outlined or until cancelled.