If you're buying as a surprise gift, be sure to enter your information and email address below. Any confirmations will be sent to you and not the recipient.

Name*
Billing Address

Former marching member, staff or volunteer?
Please make this an anonymous donation.
Paying by Credit Card?

Mail your check to:

Phantom Regiment
420 N Main St
Rockford, IL 61103

If choosing a helmet bay location, you will receive an email to do that after payment has been received.

Any donations over $500 will receive a helmet plaque. Donations made before May will have their plaques installed before summer. If you choose to make monthly payments, a minimum of two payments must be made before a plaque can be installed.

Reserve your spot before the remaining helmet bays sell out! (Sorry, but the back door donors has already been printed and is no longer available).

Donation Amount*
Do NOT use commas in the "Other Amount" field. Extended payments only valid for amounts over $500.
$
Payment Choice*
Extended payments occur monthly for 12 months. If you'd like to pay via another method, please call us at 815-261-1956.
Do you want the helmet bay recognition?
$
Approximate monthly amount shown, actual amount could vary depending on rounding. Email receipt will show actual.

Your pledge amount will be made in monthly payments. You have authorized the Phantom Regiment to charge your credit card automatically each month for the # of monthly payments shown above in the recurring amount shown above (monthly amounts may vary by a few cents due to rounding; actual amount charged will be shown on each monthly payment receipt). Credit card transactions are processed securely by Authorize.net. Any changes made to your pledge amount may incur costs to have your name removed from the trailer door or helmet bay (if applicable).

Helmet Bay Plaque

PLEASE NOTE: We reserve the right to revise any text, and we will contact you in advance if that is the case. In order to have the helmet bays decorated by the summer of 2015: a) all entries must be made by May 31st, 2015; and b) if extending payments, a minimum of two payments or $100 must be received by May 31st. Entries after June 1st will be decorated after the 2015 summer. 

For more helmet bay plaque examples, click below:   

Available Helmet Numbers*
Maximum of 27 characters per line
Maximum of 27 characters per line
Maximum of 27 characters per line
Maximum of 27 characters per line

Confirmation Page

Please verify we have your correct contact info:

Name:  {$34193125 Name}

Phone:  {$34193127 Phone}

Email:  {$34193128 Email}

 

For those that are receiving recognition, this is your last chance to VERIFY what you typed, is correct:

Door Recognition:  {$34193149 Name as to be shown on door}

---

Helmet Bay Plaque:

{$34193151 Line 1 - RESERVED FOR} (disregard this line if not using one of the 2 choices)

{$34193152 Line 2}

{$34193153 Line 3}

{$34193154 Line 4}

{$34193155 Line 5}

 

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