2026 Participating Restaurant

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Account Registration

Restaurant Name *

Restaurant Address

Best Contact Full Name *

Who is the best point of contact for event communications (usually the manager on duty the night of the event).

Email of Best Contact Indicated Above *

Phone of Best Contact *

What is the best phone number for event communications? (The restaurant general line is not usally the best number.)

Name and Title of Person Filling Out This Form (If Different From Above)

Name of Additional Participating Restaurants

If you have more than one location, please write the names and locations of all participating restaurants.

How Much Will Your Restaurant Donate in 2026? *

10%

the traditional 20%

DOFL Materials inside Restaurant *

Table Tents

Event Poster

Event Info "postcard" to include with Bill Presenters or Receipts

Please indicate materials you'd like to have in your restaurant on event day (please check all that apply.)

Would You Like a WNCAP Dining Out For Life Volunteer Ambassador in Your Restaurant During the Event?

Yes

Dining Out For Life Volunteer Ambassadors answer questions about the fundraiser and encourage guests to support WNCAP's mission.

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2026 Dining Out For Life Participating Restaurant