Donate a GO Kart - Gamers Outreach Foundation

Your Name*

Your Email*

What is the name of the hospital you'd like to make a donation to?*

How many GO Karts would you like to donate to the hospital?*

Do you work at the hospital? If so, what is your role?*

Do you know how many inpatients were admitted to the hospital last year?*

Do you have a contact at the hospital that can help us coordinate delivery arrangements?*

Hospital contact name

Hospital contact email or phone number

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