Please fill out the form below to RSVP for Give a Family a Break from Cancer charity event. RSVP’s will close at 6 pm the day of the event, Saturday, July 8th, 2017. All proceeds from GFBC will allow the Breathing Room to help 1,000 families affected by cancer in 2017 by providing services that accommodate their most critical and unique needs.Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Enter Email Confirm Email How are you going to participate in the Give a Family a Break from Cancer event?RSVP for the Give a Family a Break From Cancer event with a donation.Volunteer for the Give a Family a Break from Cancer event.RSVP Donation*Your donation includes one ticket to the Give a Family a Break from Cancer event. The event will include complimentary drinks, cocktail party hors d'oeuvres, entertainment, raffle prizes, and family-friendly activities! $25$50$100$200 (A donation of $200 supports one new family who will join the Breathing Room's circle of care in 2017.)OtherDonation of $25* Price: $25.00 Donation of 50* Price: $50.00 Donation of $100* Price: $100.00 Donation of $200* Price: $200.00 Amount of Donation:*($25 or more) General Donation to the Give a Family a Break from Cancer event.*This donation will benefit the Breathing Room's Summer Fun program and does not include an RSVP for the event. A donation of $200 supports one new family who will join the Breathing Room's circle of care in 2017. Thank you for volunteering!Agree to the event waiver, click submit, and we'll be in touch with you soon with further details.Event waiver*I understand that this event is a potentially hazardous activity and I hereby assume full and complete responsibility for any injury or accident that may occur during my participation at Give a Family a Break from Cancer event or while on the event premises. I understand that Give a Family a Break from Cancer event is organized, authorized and run by the Breathing Room Foundation; that the organizers and/or sponsors of Give a Family a Break from Cancer event are agents or employees of the Breathing Room Foundation, and that the property owners are not acting on behalf of Breathing Room Foundation. I hereby release and hold harmless the Breathing Room Foundation, and covenant not to file any suit, action, or claim against the Breathing Room Foundation, organizers and sponsors of Give a Family a Break from Cancer event, agents or employees of the Breathing Room Foundation, and the property owners for any injury, damages, liabilities, costs, expenses, or losses arising out of or in any way relating to the Give a Family a Break from Cancer event or Event Premises. I agree Payment InformationThe Breathing Room Foundation is committed to protecting you personal information. All transactions conducted on this website are encrypted to protect your privacy and your credit card information is never stored on our server. We are very proud to say that $.90 cents of every dollar supports the families affected by cancer in our circle of care.Credit Card* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20172018201920202021202220232024202520262027202820292030203120322033203420352036 Expiration Date Security Code Cardholder Name Total $0.00 NameThis field is for validation purposes and should be left unchanged.