Registration

Champions of Hope are male high school juniors or seniors who participate in a leadership, philanthropy and service program hosted by Centers for

Youth and Families. Champions will:

Earn a certificate of recognition and letter of recommendation for college applications.

Be recognized during the Evolve Gala, The Centers’ signature fundraising event.

Be promoted in the community through print publications and social media.

Program requirements:

Champions must be a junior or senior in high school. They must commit to participating in 50% of the scheduled activities and have a commit-

ment of $1,500 to be gifted or raised to benefit boys and girls served by Centers for Youth and Families. All gifts are invested in programs

that enable boys and girls to overcome trauma and abuse and create pathways to success. The Centers’ will provide support for fundraising

activities.

A minimum of $250 is required with the return of this registration form. The entire commitment must be gifted at least two weeks prior to The

Evolve Gala, Centers’ signature fundraising event, which will take place in the spring of 2021.

Each young man is required to attend 50% of program activities.

Return to Centers for Youth and Families Foundation, PO Box 251801, Little Rock, AR 72225:

A signed registration form, $250 deposit and Financial Contract

A photograph of the Champion of Hope for the program directory (email to ccarr@cfyf.org)

First Name

Last Name

Street Address (inc. Apt#, if applicable):

City

State

Zip

Phone #

Email

High School

Location (City)

Grade

Mom’s Name Dad’s Name

Mom’s Cell

Dad’s Cell

Mom’s Email

Dad’s Email

Nominated by:

Phone #/Email:

Questions? Call Candace Carr, Development Officer, 501-666-9436 x.3126 or email ccarr@cfyf.org. Learn more about The Centers for Youth and Families at: CFYF.org, Facebook.com/TheCentersAR or Instagram.com/the_centers_ar

Champions of Hope Financial Contract

The total tuition of the Champions of Hope program is $1,500, invested in changing the lives of children and youth served by programs at The Centers. A $250 deposit is due with registration form. A total of $1,500 must be paid in full 2 weeks prior to the Evolve Gala or your son will not be able to participate in The Evolve Gala.

If your son has a Champions of Hope sponsor, he or she must complete a financial contract so we can invoice or draft their payments appropriately and provide you with the correct charitable donation credit. Sponsors must complete and sign the following contract.

Automatic draft payments will be:

Deposit of $250

$250 October 15

$250 November 15

$250 December 15

$250 January 15

$250 February 15

Please choose one of the following:

_________Automatic Draft. Enclose Automatic Deduction Authorization form and

voided check from the account which you wish to be drafted.

_________I will pay in full.

__________I will pay via Venmo @thecentersarkansas

____ My check is enclosed.

_____I will pay by credit card. My credit card number is ________________________________________

Expiration date_____________ CVC _______ I will pay the 3% processing fee _______

Type of card: (circle): Mastercard VISA American Express Discover

The Centers for Youth & Families, Inc. AUTOMATIC DEDUCTION AUTHORIZATION

Company Name Contact Name _______________________________

Address ___________________________________________________________________________

City/State Zip Code ___________________________________

Phone____________________________ E-Mail ____________________________________

Gift Information:

Pledge Amount $________________ Monthly Deduction Amount $______________

Deduction Day:

_____15th of the month

Fund ___________________________________

Appeal _________________________________

Bank Name

Bank Location

(City) (State)

Type of Depositor Account:

______ Checking (Attach a voided check) ______Savings (Attach a voided deposit slip)

Bank Transit #:______________________________ Account #: _________________________

AUTHORIZATION FOR AUTOMATIC DEDUCTION

I authorize Centers for Youth & Families to withdrawal funds from my account

Customer Signature Date

Champions of Hope Calendar of Events 2019-2020 (subject to change)

Champions are required to attend at least 50% of activities

Sunday, September 29 Kick-Off Celebration and Tour

5:30 p.m. to 7:30 p.m. Centers for Youth and Families, 6501 W. 12th St.

Tuesday, October 8 Jennifer Belt, Arkansas Repertory Theatre

6 p.m. to 8 p.m. Fundraising 101

Divide into teams for brainstorming fundraising ideas

Packing welcome bags or golf bags

October 9-October 18 One-on-one fundraising coaching by appointment

4 p.m. to 5:30 p.m. No longer than 45 minutes each

Freeway Medical Building, Suite 402

Saturday, October 19 6th and Goal 6th grade Football, Little Rock School District

9:30 a.m. to 11:30 a.m. With Dr. Fitz Hill

Tuesday, October 29 Decorating for Halloween Carnival

4:30 p.m. to 6:00 p.m. Divide into teams to set up carnival games

Centers for Youth and Families, 6501 W. 12th St.

November 4-November 7 Required: Individual Photos at Photos by Melisa

By appointment only; 15 minutes or less

18601 Kanis Rd Little Rock, AR 72223

501-821-2290

Tuesday, November 19 Brent Birch, Executive Director, Little Rock Technology Park

6 p.m. to 8 p.m. Jay Chesshir, President/CEO, Little Rock Regional

Chamber of Commerce

Champions of Hope group photo

Little Rock Tech Park, 417 Main St.

Tuesday, December 3 Giving Tuesday Phone-a-thon

7 p.m. to 8:30 p.m. Freeway Medical Building, Suite 402

Saturday, December 7 Champions Service Project

Morning, Time TBD Arkansas Foodbank

4301 W 65th St.

Friday, January, 3 Ross Strength & Seped

9 a.m. to 11 a.m. Group Project

Sunday, January 12 Champions Service Project

4 p.m. to 6 p.m. Compassion Center, 3618 W. Roosevelt Rd.

Tuesday, January 28 Centers for Youth and Families: Outpatient Services &

6 p.m. to 8 p.m. Therapeutic Foster Care

Freeway Medical Building, 5800 W. 10th St, 1st floor

Sunday, February 9 Champions Service Project

2 p.m. to 5 p.m. Immerse Arkansas, 5300 Asher Ave.

Orientation, tour, service project and games with clients

Sunday, March 8 Champions Service Project

2 p.m. to 4 p.m.

Saturday, March 14 The Evolve Gala

6 p.m. Statehouse Convention Center, 101 E. Markham St.

Sunday, March 29 Closing Celebration Event and Dinner hosted by Greg Hatcher

5:30 p.m. to 7 p.m. Skip Rutherford, Dean, U of A Clinton School of Public Service

Recycle Bikes for Kids, 717 E. 10th St.