*Group/Business Name


*New Group or Returning?
ReturningNew

*Main Contact first & last name

*Contact Email

*Daytime Phone

*Street Address

*City

*Province
BCMBNBNLNTNSNUONPEQCSKYT
Postal Code

*Number of people in your group

*Tell us about your group

*Proposed Meal Date

*Alternative Meal Date

*We would like to prepare meals on a regular basis
YesNo
*Meal Preference
BreakfastDinner

*We are able to cook a meal for 100 people
YesNo
*Please check the boxes below
- We would like to create a fundraising page for our group to help support the House.- I/We understand that we will supply all ingredients required for our meal and will be responsible for the cleanup at the end of the meal.- I/We understand that anyone under the age of 19 must be supervised at all times.- I/We understand that since most children at RMHBC are immune compromised, I or any other member of my group cannot visit the house if exposed to chicken pox; measles; tuberculosis; or shingles within three weeks prior to our visit; or if myself or any member of my group has a cough; cold; influenza; sore throat; fever; runny nose; diarrhea; or vomiting.

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