Register an Event

Contact Information * Required Field

Contact Name:*
Organization:
Email Address:*
Telephone Number:
Mailing Address:

Event Information

Event Name:
Event Date:
Location:
Start Time:
End Time:
Type of Event (e.g. fashion show, golf tournament):
What is the primary goal or purpose of your event? (e.g. to raise funds, awareness):
What inspired your event:
Anticipated Funds Raised:
Which Wellspring centre would you like the funds raised to go to:
Will any other individuals or organizations receive proceeds? If yes, please list them and the portion they will receive:
Number of Participants:
Will this be an annual event:
List all event sponsors:
List any additional event stakeholders:

Affiliation with Wellspring

Are you a (Check one):
How did you hear about Wellspring:
Why do you support Wellspring:

Event Promotion

Who is the target audience:
How will the event be promoted:

Event Budget

Please note that we realize these figures are estimates. Please use your best guess; we will not hold you to these numbers. All expenses must be paid from the revenue generated from your event.

Proposed Income:

Anticipated Expenses

Venue Rental:
Food & Beverage:
Printing (tickets, posters, etc.):
Advertising:
Prizes:
Other:

Net Revenue (Proposed Income - Anticipated Expenses)

Net Revenue to Wellspring:

Budget Comments

Budget Comments:

Event Support

Wellspring is not generally able to provide staffing resources for third-party events. If you require support from Wellspring please check any of the following that may apply.
Other (please specify):