ROC STOP SEIZURES' DRIVE TO STOP SEIZURES
SPONSORSHIP REGISTRATION
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Email *
FULL NAME *
COMPANY NAME *
PHONE NUMBER *
EMAIL ADDRESS *
PHYSICAL ADDRESS *
SPONSORSHIP PACKAGE *
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Form of Payment
Acknowledgement
I acknowledge that I am interested in a sponsorship for the ROC Stop Seizures' Driving to Stop Seizures event on April 2, 2023 from 1 p.m. to 4 p.m. at Topgolf in Lake Mary, Florida.  I understand that there are a limited number of sponsorships available and the sponsorship for which I am interested may no longer be available.  I acknowledge that ROC Stop Seizures will contact me regarding the potential sponsorship upon receipt of this form.
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