Proposal To Fundraise Name* First Last Email* Organisation/CompanyAddress* Street Address Suburb State Post Code FaxEmail Title of fundraising activity or event*VenueStart Date* End Date Estimated Number of Participants*Please provide detailed information on how the income/proceeds will be allocated to Disability Sport & Recreation*100% to DSRIncome less costs to DSRDonations to DSR must be returned with donor contact details for tax purposes (please see fundraising guidelines).If known, please write the name of your local newspaper hereDisability Sport & Recreation has established guidelines to ensure that all activities comply with regulations and uphold our principles. Please confirm the following by ticking the appropriate box :* I/We have read Disability Sport & Receation's fundraising guidelines and agree to abide by them at all times. I/We agree not to use Disability Sport and Recreation’s logo without the appropriate authority I/We agree not to be involved in illegal activity, violence, aggression or undertake undue risk taking Do you have Public Liability Insurance? If YES please attach a copy of your policy below I/We indemnify Disability Sport and Recreation from liability incurred as a result of a claim arising out of an incident in relation to an activity conducted by me/us. I/We agree to contact Disability Sport and Recreation before approaching organisations for sponsorship. I/We agree to provide Disability Sport and Recreation with the opportunity to display signage and literature at the event. The event/activity will be held at an accessible venue. Public Liability Insurance Policy :*Thank you for your support of Disability Sport and Recreation. Please return this form to the Fundraising Manager to receive your authorisation to fundraise. Proposals are received regularly and we aim to respond within 5 working days. Fax: 03 9473 0115 Post: PO Box 207 Abbotsford Victoria 3067PhoneThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle AJAX powered Gravity Forms.