Laney's Golden Gala Ticket Sales

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

Single Ticket

Price: $112.50

If you purchased several tickets and know your guests' names, please list them below. If you don't know who will use your tickets, email jw[email protected] when you have those names available.

Private Table (10 Tickets)

Price: $1,125.00

If you know the guests at your private table, please list them below. If you don't know who will be at your table, email jw[email protected] when you have those names available.

Guest #2

First Last

Guest #3

First Last

Guest #4

First Last

Guest #5

First Last

Guest #6

First Last

Guest #7

First Last

Guest #8

First Last

Guest #9

First Last

Guest #10

First Last

Special requests (seating requests, wheelchair accessible, food allergies, vegetarian meal)

Total

Fashionista 5k Virtual Registration

Please note that after your PayPal transaction is completed your PayPal receipt (which should go to the email address provided during PayPal checkout) will be your confirmation!!

The Foundation may send you an email closer to race day overviewing details of the race. ALL other race information and FAQs can be found on our Fashionista 5K webpage.

Corporate Champion Pledging

Company Name (as you would like it to appear):*
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Platinum Plus
Price: $7,500.00
Platinum Plus- Pledging to donate $7,500.00 to Laney's Legacy of Hope every year for 5 years, for a total donation of $37,500.00.
Platinum
Price: $7,500.00
Platinum- Pledging to donate $7,500.00 to Laney's Legacy of Hope every year for 3 years, for a total donation of $22,500.00.
Diamond Deluxe
Price: $5,000.00
Diamond Deluxe- Pledging to donate $5,000.00 to Laney's Legacy of Hope every year for 5 years, for a total donation of $25,000.00.
Diamond
Price: $5,000.00
Diamond- Pledging to donate $5,000.00 to Laney's Legacy of Hope every year for 3 years, for a total donation of $15,000.00.
This online donation is going towards which year of your pledged donation*
Total
$0.00
Upload Company Logo
Accepted file types: jpg, Max. file size: 16 MB.
You can also email artwork as a JPEG to [email protected]. Logo MUST be emailed by deadlines provided on fundraising pages to guarantee sponsorship level benefits can be honored.

Golden Gala Sponsorship

1Your Info

2Parent's Info

3Child's Diagnosis

Your Name*
First Last
Relationship to Child*
Your Email*
Your Phone Number*
How did you find out about Laney's Legacy of Hope grant program?*

Parent/Legal Guardian's Name*
First Last
Their Email*
Their Phone Number*
Their Address*
Street Address Address Line 2 City State ZIP Code

Name of Child*
First Last
Age of Child*
Child's Date of Birth*
MM slash DD slash YYYY
Diagnosis*
Is Child Considered High Risk (Per Physician)?*
Date Diagnosed*
MM slash DD slash YYYY
Is Child Currently in Treatment?*
*If No, is treatment no longer an option (i.e. Hospice)?
Name of Hospital Child is Currently Treated at?*
Tell is this Child's Story:*
Has this child/family ever received assistance from Laney's Legacy of Hope in the past?*
What are the Family's Immediate Needs During this Time in their Child's Treatment? (Ex: Financial - rent/mortgage assistance, utility bills, gas cards, etc. or Services- boarding for animals, lawn mowed, etc.)*
By Typing your Name Below you are Certifying that the Provided Information is Correct to the Best of your Knowledge.*

Golden Gala Tickets

Please note that after your PayPal transaction is completed your PayPal receipt (which should go to the email address provided during PayPal checkout) will be your confirmation!!

The Foundation may send you an email closer to the Golden Gala overviewing details of the event. ALL other race information and FAQs can be found on our Golden Gala webpage.

Following your ticket purchase

Individual Ticket Purchases: You will not need to bring a ticket/receipt to the event. Your table number will be given to you at the registration desk after submitting your name. ***This event is an assigned seating event. If you want to sit with friends/family we recommend purchasing a whole table or be sure to submit your seating requests in the comment space provide.***
Whole Table Ticket Purchases: If you provided the names of all the individuals sitting at your table prior to submitting the form, then you will follow the same process as the Individual Ticket Purchaser’s for the day of the event. If you were unsure who would be sitting at your table when the table purchase was made you have two options…. email [email protected] by Oct 1st with the names of the guests at your table or tell your guests that they will be under your name at the registration desk the day of the event (i.e. John Smith Guest #1, John Smith Guest #2).
Any questions about your ticket order can be directed to Jenell Wolf [email protected]

Golf Scramble Sponsorship

Golf Scramble Team Registration

Please note that after your PayPal transaction is completed your PayPal receipt (which should go to the email address provided during PayPal checkout) will be your confirmation!!

The Foundation may send you an email closer to the golf scramble overviewing details of the day. ALL other golf scramble information and FAQs can be found on our Golf Scramble webpage.

Alexis Runyen

Age: 11 • Diagnosis: Stage 4 Wilm’s Tumor • Date of Diagnosis: 1/05/2017

Lexi gained her wings, July 2019, after 3 years of fighting kidney Cancer.

Throughout her battle with cancer she remained positive and lifted others up around her.

We Need Your Help!

Please consider a donation or sponsorship to help us continue our battle and help more children and families struggling with pediatric cancer.

Laney's Golden Gala Ticket Sales

Laney's Golden Gala Ticket Sales

Archives

Categories

Fashionista 5k Virtual Registration

**Please note that after your PayPal transaction is completed your PayPal receipt (which should go to the email address provided during PayPal checkout) will be your confirmation!!**

The Foundation may send you an email closer to race day overviewing details of the race. ALL other race information and FAQs can be found on our Fashionista 5K webpage.

Corporate Champion Pledging

Golden Gala Sponsorship

Golden Gala Tickets

**Please note that after your PayPal transaction is completed your PayPal receipt (which should go to the email address provided during PayPal checkout) will be your confirmation!!**

The Foundation may send you an email closer to the Golden Gala overviewing details of the event. ALL other race information and FAQs can be found on our Golden Gala webpage.

Following your ticket purchase

Golf Scramble Sponsorship

Golf Scramble Team Registration

**Please note that after your PayPal transaction is completed your PayPal receipt (which should go to the email address provided during PayPal checkout) will be your confirmation!!**

The Foundation may send you an email closer to the golf scramble overviewing details of the day. ALL other golf scramble information and FAQs can be found on our Golf Scramble webpage.

Alexis Runyen

Age: 11 • Diagnosis: Stage 4 Wilm’s Tumor • Date of Diagnosis: 1/05/2017

We Need Your Help!

Piper Irias

Age: 2 • Diagnosis: Stage 4 Neuroblastoma • Date of Diagnosis: 05/17/19

We Need Your Help!

Jeremiah Reedy

Age: 2 • Diagnosis: Rhabdomyosarcoma • Date of Diagnosis: 6/20/2019

We Need Your Help!

Vincent Nowroozi

Age: 18 months old • Diagnosis: Atypical Teratoid Rhabdoid tumors (ATRT) • Date of Diagnosis: 6/19/2019

We Need Your Help!

Xavier Ortiz

Age: 3 • Diagnosis: Nuerofibromatosis 1 • Date of Diagnosis: 05/01/16

We Need Your Help!

Caden Davis

Age: 9 • Diagnosis: Philadelphia Acute Lymphoblastic Leukemia (ALL) • Date of Diagnosis: 5/12/18

We Need Your Help!

Lucas Brown

Age: 5 months old • Diagnosis: Malignant Rhabdoid Tumor (MRT) • Date of Diagnosis: 2/12/2019

We Need Your Help!

Megan Martin

Age: 11 (2007- January 22nd 2019) • Diagnosis: Acute Myeloid Leukemia (AML) • Date of Diagnosis: 5/11/17

We Need Your Help!

Shailey Kimmel

Age: 5 • Diagnosis: Stage 4 Hodgkin lymphoma • Date of Diagnosis: 12/17/2018

We Need Your Help!

Celia Cosentino

Age: 9 • Diagnosis: Brain Tumor • Date of Diagnosis: 2018

We Need Your Help!

Julia Adams

Age: 2 • Diagnosis: Clival Chordoma • Date of Diagnosis: 11/09/2018

We Need Your Help!

Chloe Koenig

Age: 10 • Metastatic Ewing’s sarcoma stage 4 • Date of Diagnosis: 10/25/2018

We Need Your Help!

Saniyah Muhammad

Age: 8 • Diagnosis: Leukemia • Date of Diagnosis: 03/28/2018

We Need Your Help!

Anthony Myers

Age: 16 • Diagnosis: Stage 3 Anaplastic Astrocytoma (Brain cancer) • Date of Diagnosis: 10/21/2018

We Need Your Help!

Benjamin Reinhold

Age: 7 • Diagnosis: Diffuse Intrinsic Pontine Glioma (DIPG) • Date of Diagnosis: 09/09/2018

We Need Your Help!

Blaze Troutman

Age: 8 • Diagnosis: Acute lymphoblastic leukemia (ALL) • Date of Diagnosis: 07/09/2019

We Need Your Help!

Kierra Broadwater

Age: 10 (March 2008 - December 2018) • Diagnosis: Acute lymphoblastic leukemia (ALL) • Date of Diagnosis: 08/02/2012

We Need Your Help!

Liam Simpson

Age: 3 • Diagnosis: Alveolar Rhabdomyosarcoma • Date of Diagnosis: 05/01/2018

We Need Your Help!

Juwan Adams

Age: 16 • Diagnosis: Refractory Hodgkinds Lymphoma stage 4B • Date of Diagnosis: 04/17/2016

We Need Your Help!

Scarlet Ornelas

Age: 2 • Diagnosis: Neuroblastoma stage 4 high risk • Date of Diagnosis: 11/27/2017

We Need Your Help!

Michael Gallagher

Age: 9 months old • Diagnosis: AML (Acute Myeloid Leukemia) • Date of Diagnosis: 06/16/2016

We Need Your Help!

Please note that after your PayPal transaction is completed your PayPal receipt (which should go to the email address provided during PayPal checkout) will be your confirmation!!

Please note that after your PayPal transaction is completed your PayPal receipt (which should go to the email address provided during PayPal checkout) will be your confirmation!!

Please note that after your PayPal transaction is completed your PayPal receipt (which should go to the email address provided during PayPal checkout) will be your confirmation!!