Looking to raise funds for your program?
February 1, 2014 Winter Fundraiser Kinship is inviting non-profit organizations (youth sports programs, school teams, church youth groups and mission trips or service organization) to join us in raising funds for youth programs in the Princeton Community. Individuals and Businesses are also invited to join the fun and raise funds for Kinship Youth Mentoring of Princeton. Non-Profit Organizations: Funds raised by non-profit groups will be split with Kinship Youth Mentoring of Princeton with 70% staying with your program & 30% going to Kinship. If you would like your organization to participate please contact the Kinship Office and request a “Kinship Plunge Organization Agreement Form.” Complete and Return the Agreement Form to the Kinship Office by January 24, 2014. When: Saturday February 1, 2014. Check-In 11:00 -11:45 a.m. Plunging starts at Noon. Where: Green Lake, Isanti County, Main Access Located 1 mile south of Highway 95 on Xenon. Park: Park at the Word of Life or Neighbors to Nations Churches on Highway 95 East of Princeton. Look for signs. Shuttle bus will bring you to and from the landing. There is limited parking by the landing. Shuttle buses will start running at 11 a.m. and go until all plungers are back to the lots. Who: Plungers must be 12 or older and in good health and must raise a minimum of $100 in pledges. Waivers of Liability must be signed and plunger under 18 must be accompanied by parent, coach or the group adult supervisor. Cost: Minimum of $100 in collected pledges per plunger. Mandatory Pre-Registration: Thursday, January 30, 2014 from 5 to 8 at the High School. The Organizations representative needs to turn in the following at preregistration: 1. Organization Plunger Roster; 2. Pledge Money (Kinship and Organization will count and verify split); 3 Each Team Members completed and signed “Individual Registration/Release Form”. Note: If Preregistration date does not work for your organization contact Kinship at 763-631-5967 and we can make arrangements for a day prior to January 30. This promises to be a very fun day. Team competitions and costumes are encouraged. Make a day of it, come for the Plunge and enjoy a fun family atmosphere. More Info: Contact Kinship Youth Mentoring of Princeton 763-631-5967 or
[email protected]
2014 Winter Fundraiser
Organization Agreement Form Return Completed Form by January 24, 2014 to Kinship Office. Kinship Youth Mentoring of Princeton 604 So. 3rd St., #151; Princeton, MN 55371 or
[email protected]
To Kinship Youth Mentoring of Princeton: YES! The following organization/program has reviewed the information regarding the Annual KINSHIP PLUNGE Fundraiser to be hosted by the Kinship Youth Mentoring of Princeton (KYMP) and would like to participate. Our organization’s governing board has approved the participation in this event. Please consider the following organization for approval to participate in the February 1, 2014 KINSHIP PLUNGE Winter Fundraiser.
Organization Name: Date & State of Incorporation: Contact Person/Title: Contact Address: Contact Phone & E-mail: Number of Expected Plungers: Is the organization an IRS 501 c (3): Federal Employer Identification Number (EIN): Please attach a copy of organizations Articles of Incorporation and IRS 501 © (3) designation letter. Princeton Team Name or 501 c (3) umbrella organization name: KINSHIP PLUNGE Mission Statement: Kinship Youth Mentoring of Princeton is offering this event for the benefit of Princeton Youth and/or the Princeton Community. The above organization agrees all funds received from this KINSHIP PLUNGE event will be used exclusively to further the above mission statement and also agrees to the terms on page 2 of this registration form. I hereby certify that I have the authority to bind the registering organization to this agreement and that the forgoing is true and correct to the best of my knowledge.
Signature: Print Name: Title:
Date:
Kinship Plunge 2014 Winter Fundraiser - Organization Agreement Form (Continued)
Participating organizations agree as follows: 1.
All plungers must be at least 12 years old and in good health. Plungers under 18 must be accompanied by parent, guardian, coach or adult supervisor. It is the responsibility of each organization to ensure the age of registrants and to present Registrations, Waiver and Pledge Sheets for all participants to KYMP.
2.
All plungers must have a minimum of $100 in pledges. All pledges must be collected and presented by the day of the event.
3.
Make all checks payable to Kinship Youth Mentoring. Kinship will distribute funds back to organizations after the event. All funds received by Kinship will be distributed as follows: 70% to the Plunging Organization and 30% to Kinship Youth Mentoring. Dishonored checks will be the responsibility of the Plunging Organization.
4.
The Organizations representative must attend Pre Registration Thursday, January 30, 2014 from 5 to 8 at the High School. The following items must be turned in at preregistration: Organization Plunger Roster Pledge Money (Kinship and Organization will count and verify split) Each Team Members completed and signed “Individual Registration/Release Form. Organization representative will be given the following at Pre Registration: Wrist bands - Allows plunger to go directly to Plunge Line at the event. Hats for those who turned in $100 in pledges. Reminders for Plunge Day Note: If Preregistration date does not work for your organization contact Kinship at 763-631-5967 and we can make arrangements for a day prior to January 30
5.
Photographs/videos of the event may be taken. All plungers participating consent to use of either.
6.
Costumes and theme plunges are recommended. Costumes MUST be family/community appropriate.
7.
All individual plungers (not a member of participating organizations/teams/ or groups) will donate all pledges to Kinship Youth Mentoring of Princeton.
8.
All Plungers, PLUNGE AT THEIR OWN RISK. Plungers should contact their personal physician before plunging. All plungers must return to KYMP through your organization the Organization Agreement to Participate, a Wavier of Liability and Release forms. Youth between 12-17 years must have signed parent/guarding form verified by participating adult supervisor. If you do not have the required forms, you WILL NOT be allowed to participate. Plungers must not consume alcohol or drugs prior to plunging or at anytime on-site. Kinship reserves the right to refuse any person that does not comply with the above rules. This is a family event and we want all participants to behave in a respectable manner.
9.
Kinship will provide a warm changing facility. KYMP will not furnish towels or blankets, plungers must bring their own.
10. Plungers must exit the water immediately after entry. Plungers MUST obey all instructions of divers & Emergency and Medical personnel on-site. 11. There will not be an alternate date for the event. If the Plunge is cancelled due to weather, pledges received will be retained and distributed as described above. There will be NO refunds of pledges. USE of Funds: Organizations/teams/groups agree to use all funds raised from the KINSHIP PLUNGE to the benefit of youth in our community or the community as a whole. Use of funds will not violate any laws, statutes, ordinances or tax laws. ORGANIZATIONS AGREE THAT NO PORTION OF THE FUNDS WILL BE USED FOR ANY ILLEGAL PURPOSE. Wavier and Release from Liability: In consideration of participation in the KINSHIP PLUNGE event, the named organization hereby releases Kinship Youth Mentoring of Princeton, it’s participants, volunteers, board of directors and officers, their heirs, administrators, executors, or assigns from any and claims, demands, actions or account of any loss, damage, or injury to persons or property relating in any way to the KINSHIP PLUNGE.
Organization Plunger Roster Kinship Plunge 2014 Winter Fundraiser All waivers must be signed and turned in at registration before teams can plunge. Youth between 12 - 17 years must have waiver signed by parent/guarding and verified by participating adult supervisor. Please staple or clip all waivers to this Plunger Roster and turn in at pre-registration or on-site registration.
Organization's Name: ______________________________________
Contact Person: ___________________________________________
Contact Email: ___________________________________________
Contact Phone:_____________________________________________
Plunger's Name
Address
Kinship Youth Mentoring of Princeton is hosting this event for the benefit of Princeton Youth and/or the Princeton Community. When: Saturday February 1, 2014. On-site check-in 11:00 – 11:45 a.m. Plunging starts at noon. Pre Registration: Thursday, January 30, 2014 from 5 to 8 at the High School The Organizations representative needs to turn in the following at preregistration: 1. Organization Plunger Roster; 2. Pledge Money (Kinship and Organization will count and verify split); 3 Each Team Members “Individual Registration/Release Form Where: Green Lake, Isanti County, Main Access located 1 mile south of Hwy 95 on Xenon. Park: Park at the Word of Life or Neighbors to Nations Churches on Highway 95 East of Princeton. Look for signs. Shuttle bus will bring you to and from the landing. There is limited parking by the landing. Shuttle buses will start running at 11 a.m. and go until all plungers are back to the lots. All inquires: Should be made to The Kinship office at 763-631-5967 or
[email protected] Emergency Contact
Emergency Contact Phone
Age
Signed Waiver Attached
Pledge Amt.
Paid Amt.
Total Pledge/Paid Amount
$
(Form can be duplicated for additional plungers)
$
Minimum of $100 in collected pledges per plunger