2021 USABA Breakfast with Champions In-Person Registration

Thank you for purchasing your ticket for the 12th annual USABA Breakfast with Champions!

We are thrilled to be offering an in-person experience for the Breakfast With Champions at the state-of-the-art US Olympic and Paralympic Museum in Colorado Springs. Breakfast with Champions is the United States Association's annual fundraising event for our athletes and members across the US who are blind and visually impaired.

This event will be hosted on Friday, October 29, 2021. Doors open and breakfast begins at 7:30 am MDT, with the program starting at 8:15 am MDT. By completing this form and submitting your payment, your name will be added to the guest list for the event.

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* 1. Please enter your contact information

Name *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Email Address *

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* 2. Would you like to sign up to receive the USABA Newsletter?

Yes

I already subscribe to the USABA Newsletter

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* 3. Which of the following best describes you? (Select all that apply)

USABA Member

USABA Friend/ Donor/ Supporter

Corporate Partner

USOPC/ NGB Staff

Other (please specify)

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* 4. Tickets for the in-person Breakfast With Champions are $45, and we ask that you consider making an additional donation to further USABA's mission and programs.

$45 donation will purchase a ticket to the Breakfast With Champions - $45 USD

$95 donation will purchase an event ticket and a pair of USABA eyeshades - $95 USD

$245 donation will purchase an event ticket and support an athlete attending a USABA ski camp - $245 USD

$495 donation will purchase an event ticket and equipment kit for a local blind soccer team - $495 USD

$995 donation will purchase an event ticket and provide training for an aspiring Paralympian at the Paris 2024 Paralympic Games - $995 USD

You will pay at the end of this survey.