Donate CAD First Name Last Name Phone Email Billing Address Billing Address Billing Address Billing Address Billing Address Billing Address State AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Billing Address My employer matches donations Yes No Employer / Company Name I would like to dedicate this donation Yes No Tribute Type of Tribute In Memory of In Honor of Tribute Name Email for Notification Address Address Address Address Address Address State AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Address Message Select Donation Amount $1000 $500 $250 $100 $50 $25 $10 $5 Other AmtOther Amt Processing Costs Yes No Please offset my processing costs, so more of my money can benefit R4MH. 3% will be added to my gift Credit Card TOTAL $ Racing for Mental Health (R4MH) is a nonprofit, tax-exempt, charitable organization under Section 501(c)(3) of the Internal Revenue Code. Your contribution is tax-deductible. A receipt of your donation will be sent to the email you provided above.View the privacy policy for more information. If you are human, leave this field blank. SUBMIT