Hits for the Cure General Donation

Donate by Hits

"*" indicates required fields

Name*

First Last

Email*

Phone*

Fundraiser*

Choose the Fundraiser you would like to donate to.

Team Name*

Select the Team you would like to apply your Donation to.

Your Donation 'Per Hit'*

Average amount of hits per event is around 400. Donating $0.10 per hit would be a donation of $40.00. (# of Hits * Donation Amount = Total)

Credit Card Number

Expiration Date*

CVC Number*

Address*

Street Address City State ZIP Code

Confirmation*

I confirm everything is correct.

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