2019 Beneficiary Nomination

The Riff Ridgel Crawfish CookOff Benefit is a non-profit 501(c)3 organization dedicated to providing support to families and individuals in the local community whose lives have been impacted by a catastrophic illness or accident. Please provide the following information regarding the applicant and contact person if other than applicant. Be sure to print clearly. As a beneficiary of the Riff Ridgel Crawfish CookOff Benefit, you are agreeing to provide information as requested by the Board of Directors, including photographs, which may be used to advertise the event. Submission of this form does not confirm engagement.
  • Applicant Information

  • Contact Person Information

    I understand that by clicking this radio button, the entered Name of Applicant will serve as his/her signature and will serve any and authorize the information on this form.