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Father’s Day Lighthouse

Donation Amount*

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$20.00

$50.00

$100.00

$250.00

$500.00

$1,000.00

Other:

Designation of donation(club/sport/program name to receive donation)

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Message

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Contact Information

Please complete your contact information and a donation receipt will be sent to you upon receipt.

First Name

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Last Name

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Street Address

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City

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Zip/Postal

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Phone

Number Required

Confirmation Email

Confirmation Email *

Email Required