Pledge Payment Form

Thank you for your support of the 2023 Duck Derby. Please fulfill your pledge by selecting the package that corresponds to your invoice.

Are you paying a Sponsorship Pledge or a Duck Adoption Pledge?(Required)

Sponsorship Pledge

Duck Adoption Pledge

Sponsorship Amount

Duck Adoption Amount

Account # (as listed on invoice)

Email(Required)

Phone(Required)

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State ZIP Code

Comments

Total

Credit Card

Card Details

Cardholder Name

Boys & Girls Clubs of Lanier