31st Annual 'A Starry Starry Night' Gala

Step 1 — Select Tickets

  Quantity Price Ticket Type
$25,000.00 Presenting Partner (Table of 8) - SOLD OUT!!!
$10,000.00 Fund a Cure Partner (Table of 10)
$10,000.00 Auction Partner (Table of 10)
$5,000.00 Grand Evening Partner (Table of 10)
$4,000.00 Evening Partner (Table of 8)
$325.00 Patron
$275.00 Benefactor
$225.00 Supporter
Additional Questions
Name all ticket holders* Seated at our table will be
 
Waiver

WAIVER/RELEASE:
ASSUMPTION OF RESPONSIBILITY, RISKS AND LIABILITY WAIVER BY SIGNING THIS LEGAL DOCUMENT, YOU WILL BE GIVING UP CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE - PLEASE READ CAREFULLY. 


Assumption of Risks and Assumption of Responsibility - I REALIZE THAT THERE ARE POTENTIAL RISKS INHERENT IN MY PARTICIPATION IN THIS EVENT. I am physically fit to participate in the event, and there are no medical or health concerns that would affect my participation in a physically demanding event. I freely and voluntarily accept and assume all such risks, dangers and hazards and the  possibility of personal injury, death, violence, property damage or loss, during all the time of this event, resulting from the travel arrangements, attendance at the event and any other related activities during this event. I accept my responsibility to abide by the laws of the country, to ensure that I have adequate medical coverage, protect personal possessions, and obey all the rules set out for this trip/event. 


Waiver and Release -  BY SIGNING THIS WAIVER AND RELEASE I HEREBY ACKNOWLEDGE that in consideration of approval to participate in this event, I and any of my personal representatives, hereby agree to waive and release any and all claims on behalf of myself, heirs, executors and administrators against Juvenile Diabetes Research Foundation Canada, all sponsors, officials, employees, volunteers, organizers and any other party or person connected with this event in any way for any actions or causes of action, including negligence, blame or liability, demand, harm, loss of property, injury, illness or death which may directly or indirectly result from my participation in the event and activites associated with it. I also agree to hold harmless and indemnify Juvenile Diabetes Research Foundation Canada from any and all causes of action, demands, expenses, losses, costs and damages I incur as a result of my participation in this event. I acknowledge and agree that I have read this waiver and understand that I am giving up substantial rights by signing this wavier. I sign this waiver voluntarily.  I shall permit the free use of my name and picture in publicity resulting from the event. 

For information about JDRF’s Privacy Policy, visit www.jdrf.ca or contact JDRF’s Chief Privacy Officer by e-mail at privacy.officer@jdrf.ca, by phone at 1.800.287.3533, or by mail at 235 Yorkland Blvd.,Suite 600. Toronto, ON M2J 4Y8.


?              I have read and fully understand and agree with the contents of this Waiver/Release prior to participating in the event. 


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Billing Address

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Additionally, verify that your card number, card security code (a three digit number on the back of your card's signature panel for Visa, MasterCard and Discover transactions and a four digit number on the front of the card for American Express transactions) and expiration date are correct.