Stars Dancing for Parkinson’s Sponsorships

All proceeds raised through your sponsorship for this event go directly to support our Wellness Programs, to further the latest therapeutic strategies and capture outcome measures that will continue to elevate the breadth and depth of movement disorders services in Connecticut.

To view sponsorship opportunities, please click here.

You may register for a sponsorship by filling out the form below, or checks can be mailed to the following address:

Hartford Hospital
Attn: Gina Fleming
80 Seymour Street, P.O. Box 5037
Hartford, CT 06102-5037
(Reference “Stars Dancing” in the memo)

Stars Dancing Sponsor Form

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Next Steps: Install a Payment Add-On

To accept donations via this form you will need to install one of our payment add-ons. To learn more about your payment add-on options, visit the following page (https://www.gravityforms.com/blog/payment-add-ons). Important: Delete this tip before you publish the form.
Contact Name(Required)
Billing Address(Required)
Email(Required)
Sponsorship Level(Required)
Meal choices include boneless breast of chicken, north atlantic salmon, and grilled vegetable risotto
We will try to accommodate your seating request

Tribute (Optional)

If you would like to make your sponsorship in memory or in honor of someone, please fill out the information below.
Name
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Credit Card

Replace this field with a field specific to your payment gateway whenever possible.

Please note that PayPal and Electronic Checks are currently not available. We ask that you please use a credit card for payment.