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Celebration Gala

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srfcelebrationsponsorship_materials3_550
Saturday, April 13, 2019
Red Rock Resort 6:00 p.m.

All proceeds directly support southern Nevada's
only not-for-profit, faith-based health care system.

Registration Form

Please fax this completed form to 702.616.5751; mail to
St. Rose Dominican Health Foundation, 3001 St. Rose Parkway, Henderson, NV 89052
Attention: Barbara Davis; or email to: Barbara.Davis@DignityHealth.org. 


Name ___________________________________________________
Organization ______________________________________________
Address __________________________________________________
City ____________________________________State _______ Zip ____________
Email Address ______________________________________
Mobile Phone ________________________________ Work Phone __________________
❏ I am unable to participate, but would like to make a donation. Donation amount $ ______________
❏ Presenting Sponsor - $50,000 ❏ Silver Sponsor - $10,000 ❏ Full-Page Color Program Ad - $2,500
❏ Platinum Sponsor - $25,000 ❏ Bronze Sponsor - $7,500 ❏ Individual Seat - $500
❏ Gold Sponsor - $15,000 ❏ Copper Sponsor - $5,000
Payment Type: ❏ Cash ❏ Check* ❏ Charge ❏ Invoice
Please bill my credit card: ❏ Visa ❏ Mastercard ❏ American Express
Card # ____________________________Exp. Date ____________________
Name on Card _______________________________________________
Address _____________________________________________________
City _____________________________________State _______ Zip ____________
Signature ____________________________________Date ________________________
*Make checks payable to St. Rose Dominican Health Foundation
Thank you for supporting Dignity Health - St. Rose Dominican. Once we receive your completed form, a representative
from the Health Foundation will contact you to discuss event arrangements, sponsorship benefits, and recognition.
Contributions to the St. Rose Dominican Health Foundation may be tax deductible pursuant to the

Download Registration Form

  BUSINESS NAME CelebrationGala
  ADDRESS
Las Vegas, NV
  CITY Las Vegas
  STATE NV
  SERVICES OFFERED
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