DRC Derby Sponsorship Payment Form DRC DERBY HAS BEEN POSTPONED – NEW DATE TO BE ANNOUNCED Derby Sponsorship Form Graded Stakes Race Sponsors $1,500 Kentucky Derby Sponsor: 6 DRC Derby tickets plus $60 in race raffles**** $1,000 Preakness Sponsor: 4 DRC Derby tickets plus $40 in race raffles*** $ 700 Belmont Stakes Sponsor: 3 DRC Derby tickets plus $30 in race raffles** $ 500 Breeder's Cup Sponsor: 2 DRC Derby tickets plus $20 in race raffles** Race Track Sponsors $300 Winner's Circle Sponsor: $20 in race raffles plus 1 DRC Derby ticket* $100 Starting Gate Sponsor: $10 in race raffles* $50 Finish Line Sponsor: $5 in race raffles* Sponsorships include: ****DRC Corporate consultation and choice of an entry level training package in addition to the following: ***Corporate name on promotional materials for youth program beneficiaries in addition to the following: **Corporate name/logo displayed on all pre-event Derby materials received before 4/1/2020 in addition to the following: *Corporate name displayed in event day program, at the evening event and DRC website.SubtotalTotal $0.00 Sponsor Information Name* First Last Title Company Name Phone/Cell Number*Email* Enter Email Confirm Email Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Terms of payment I certify that the credit card used for payment is in my name or company name and I authorize payment to DRC through PayPal for DRC Derby Sponsorship. I understand and agree that no refunds will be issued. Signature (to be typed in)* By signing my name in the signature box, I agree to the terms of payment as stated above.CAPTCHAEmailThis field is for validation purposes and should be left unchanged.