Pirates Charities Wins for Kids Form

Join Pirates Manager Clint Hurdle, his wife Karla and ROOT SPORTS to support the 2013 Wins for Kids campaign.

Wins for Kids raises funds to support Pirates Charities and the Prader Willi Syndrome Program at the Children's Institute of Pittsburgh.

For a one-time donation OR a monetary pledge for each Pirates win during the regular season, you can receive great incentives and help us to improve the lives of children and adults in our community. In 2012, more than $39,000 was raised. Let's do even better in 2013!

All monies that are raised through Wins for Kids are split evenly between Pirates Charities and the Prader-Willi Program at the Children's Institute. Prader-Willi Syndrome (PWS) is a rare, complex genetic disorder that affects many parts of the body and the Children's Institute of Pittsburgh is the only hospital-based site in the world offering treatment for this population. Clint and Karla's 10-year old daughter Maddie has Prader-Willi.

In return for making a contribution to Wins for Kids, you'll receive*:

• One-time donation of $25 or more = Specially-designed Clint Hurdle Wins for Kids cap.
• $1/win = Specially-designed Clint Hurdle Wins for Kids cap, plus two (2) tickets to an upcoming Pirates (Monday-Thursday) home game.
• $5/win = Specially-designed Clint Hurdle Wins for Kids cap, two (2) tickets to an upcoming Pirates (Monday-Thursday) home game, and an autographed bat of your choice from a current Pirates player or coach (subject to availability).

*Incentive items only available to shipping addresses within the United States and Canada.

Pledging is easy, simply fill out the form below.
Together, we can make every Pirates win make a difference!

Please note, all fields marked with an asterisk (*) are required for submission.

---

 Pledge or Donation Type

* Select one	Make a one-time donation      Pledge $1 per win      Pledge $5 per win

 Donation Amount

You will receive a specially-designed Clint Hurdle Wins for Kids cap.

* Enter one-time donation amount (minimum $25)

 $1 Per Win Pledge Information

You will receive a specially-designed Clint Hurdle Wins for Kids cap, plus two (2) tickets to an upcoming Pirates (Monday-Thursday) home game.

 $5 Per Win Pledge Information / Player or Coach Selection

You will receive a specially-designed Clint Hurdle Wins for Kids cap, two (2) tickets to an upcoming Pirates (Monday-Thursday) home game, plus an autographed bat of your choice from a current Pirates player or coach (subject to availability).

* Enter player or coach for autographed item

---

 Billing Information

* First Name		* Last Name
* Address		Address 2
* City		* State/Province	- Select One ------------------   -- STATES -- AL - Alabama AK - Alaska AS - American Samoa AZ - Arizona AR - Arkansas CA - California CO - Colorado CT - Connecticut DE - Delaware DC - Dist. of Columbia FM - Fed. St. of Micronesia FL - Florida GA - Georgia GU - Guam HI - Hawaii ID - Idaho IL - Illinois IN - Indiana IA - Iowa KS - Kansas KY - Kentucky LA - Louisiana ME - Maine MH - Marshall Isls. MD - Maryland MA - Massachusetts MI - Michigan MN - Minnesota MS - Mississippi MO - Missouri MT - Montana NE - Nebraska NV - Nevada NH - New Hampshire NJ - New Jersey NM - New Mexico NY - New York NC - North Carolina ND - North Dakota MP - Northern Mariana Isls. OH - Ohio OK - Oklahoma OR - Oregon PW - Palau PA - Pennsylvania PR - Puerto Rico RI - Rhode Island SC - South Carolina SD - South Dakota TN - Tennessee TX - Texas UT - Utah VT - Vermont VI - Virgin Islands VA - Virginia WA - Washington WV - West Virginia WI - Wisconsin WY - Wyoming   -- US ARMED FORCES -- AE - Africa AA - Americas AE - Canada AE - Europe AE - Middle East AP - Pacific   -- PROVINCES -- Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon   Non-US/Canada
* Zip/Postal Code		* Country	- Select One ------------------ United States Canada

* Day Phone		* Evening Phone
Fax Number
Mobile Phone	Enter your mobile phone information to receive text messages & updates from pirates.com and MLB.com (Optional, if checked, 'Mobile Phone' must be provided). Msg&Data Rates may Apply. Reply "Stop" to cancel. Text "Help" or email mlb-mobile-cs@mlb.com for assistance. Expect 1-2 messages per week.
* Birth Date	- mm - 123456789101112 - dd - 12345678910111213141516171819202122232425262728293031 - yyyy - 20132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119201919191819171916191519141913
* E-mail Address
	I would like to receive commercial e-mails from pirates.com and MLB.com.

---

 Shipping Information

Check this box to specify a different shipping address (if unchecked, your Billing Information will be used).

* First Name		* Last Name
* Address		Address 2
* City		* State/Province	- Select One ------------------   -- STATES -- AL - Alabama AK - Alaska AS - American Samoa AZ - Arizona AR - Arkansas CA - California CO - Colorado CT - Connecticut DE - Delaware DC - Dist. of Columbia FM - Fed. St. of Micronesia FL - Florida GA - Georgia GU - Guam HI - Hawaii ID - Idaho IL - Illinois IN - Indiana IA - Iowa KS - Kansas KY - Kentucky LA - Louisiana ME - Maine MH - Marshall Isls. MD - Maryland MA - Massachusetts MI - Michigan MN - Minnesota MS - Mississippi MO - Missouri MT - Montana NE - Nebraska NV - Nevada NH - New Hampshire NJ - New Jersey NM - New Mexico NY - New York NC - North Carolina ND - North Dakota MP - Northern Mariana Isls. OH - Ohio OK - Oklahoma OR - Oregon PW - Palau PA - Pennsylvania PR - Puerto Rico RI - Rhode Island SC - South Carolina SD - South Dakota TN - Tennessee TX - Texas UT - Utah VT - Vermont VI - Virgin Islands VA - Virginia WA - Washington WV - West Virginia WI - Wisconsin WY - Wyoming   -- US ARMED FORCES -- AE - Africa AA - Americas AE - Canada AE - Europe AE - Middle East AP - Pacific   -- PROVINCES -- Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon   Non-US/Canada
* Zip/Postal Code		* Country	- Select One ------------------ United States Canada

---

 Payment Information

* Name on Credit Card		* Credit Card Number
* Credit Card Expiration	- mm - 123456789101112 - yyyy - 20132014201520162017201820192020202120222023	* Credit Card Type	- Select One ------------------ Visa MasterCard American Express Discover

 
  
 

By making a pledge or donation to the Pirates Charities Wins For Kids campaign, I acknowledge that I have read, understand and agree to be bound by the pirates.com Website Terms of Use Agreement and Privacy Policy.

Pirates Charities is a recognized 501(c) (3) charitable organization. The official registration and financial information of Pirates Charities may be obtained from the Pennsylvania Department of State by calling toll free, within Pennsylvania, 1 (800) 732-0999. Registration does not imply endorsement.