MAD MUDDER SPONSOR AND PAYMENT FORM
Be a part of one of the most exciting events happening in the Moscow area this summer ! The Mad Mudder is a charity event that will benefit the Madisonville Fire Department. The participants will take on the Mad Mudder on August 19, 2023 starting at 9:00 AM. As a sponsor, your donation will help to fund the event. All remaining proceeds from the sponsors will go directly to the Madisonville Fire Department. Join us as a supporter by selecting one of the levels below.
Sponsor Name or Business*
Contact Person*

First NameLast Name
E-mail*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

with area Code
Website
Pay Now with PayPal*
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Platinum Sponsorship$150.00
Name on back of our T-shirt in large font size

Gold Sponsorship$100.00
Name on back of our T-shirt in medium font size

Silver Sponsorship$50.00
Name on back of our T-shirt in small font size

Other Amount$5.00
(Increments of $5.00)

Quantity
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Total $0.00
If paying by check please print this form out and mail along with your payment to:
Madisonville Mud Run
101 Meadowood Lane
Madison Twp, PA 18444
You will receive a confirmation e-mail notifying you when payment is received and check(s) cleared.
For any concerns, questions or other payment options please contact us at madmudrun@yahoo.com
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MAD MUDDER SPONSOR AND PAYMENT FORM