2022 Dine Out for Mom Restaurant Sign-up

Dine Out for Mom 2022 will be held on Thursday, October 27. Last year, over 90 restaurants throughout the Upstate partnered with Let There Be Mom to help preserve the legacies of moms and dads with life threatening illnesses. These restaurants donated 20% of their total sales on DOFM day to LTBM; together they gifted almost $67,000. LTBM handles all of the marketing and advertising for Dine Out for Mom. If you have a spot in your heart for children who may lose their parent, or for parents who may not get to see their children grow up, then this is an event where you can participate and make a difference. Our primary goal is to help these families. In addition, you will likely experience a positive impact on your business. On average our restaurant partners see a 35% increase in business and of-course, get introduced to many new customers. If your restaurant would like to sign-up to for DOFM 2022, please complete our Restaurant Registration.

DOFM Restaurant Registration

2022 Dine Out for Mom Restaurant Registration

Restaurant Name*
Contact Name*
First Last
Contact Email*
Contact Phone*
Is it okay to text you at this number?*
- Yes
- No
Best Time to Call
Number of locations participating*
Restaurant Information
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Hours of Operation*
# of tables at this location*
# of visible staff members working at this location on 10/27/22*
We will provide event buttons for all of your visible staff members to wear on DOFM day; these can be passed from one shift to the next.
Restaurant Information (2 locations)
Address (location #1)*
Street Address Address Line 2 City State ZIP Code
Phone (location #1)*
Hours of Operation (location #1)*
Will all of your locations have the same hours of operation on Thursday, October 27?*
# of tables at this location*
# of visible staff members working at this location on 10/27/22*
We will provide event buttons for all of your visible staff members to wear on DOFM day; these can be passed from one shift to the next.
Contact for location #1 (manager/owner):
Address (location #2)*
Street Address Address Line 2 City State ZIP Code
Phone (location #2)*
Hours of Operation (location #2)*
# of tables at this location*
# of visible staff members working at this location on 10/27/22*
We will provide event buttons for all of your visible staff members to wear on DOFM day; these can be passed from one shift to the next.
Contact for location #2 (manager/owner):
Restaurant Information (3 locations)
Address (location #1)*
Street Address Address Line 2 City State ZIP Code
Phone (location #1)*
Hours of Operation (location #1)*
Will all of your locations have the same hours of operation on Thursday, October 27?*
# of tables at this location
# of visible staff members working at this location on 10/27/22*
We will provide event buttons for all of your visible staff members to wear on DOFM day; these can be passed from one shift to the next.
Contact for location # 1 (manager/owner):
Address (location #2)*
Street Address Address Line 2 City State ZIP Code
Phone (location #2)*
Hours of Operation (location #2)*
# of tables at this location
# of visible staff members working at this location on 10/27/22*
We will provide event buttons for all of your visible staff members to wear on DOFM day; these can be passed from one shift to the next.
Contact for location #2 (manager/owner):
Address (location #3)*
Street Address Address Line 2 City State ZIP Code
Phone (location #3)*
Hours of Operation (location #3)*
# of tables at this location*
# of visible staff members working at this location on 10/27/22*
We will provide event buttons for all of your visible staff members to wear on DOFM day; these can be passed from one shift to the next.
Contact for location #3 (manager/owner):
Restaurant information (4 Locations)
Address (location #1)*
Street Address Address Line 2 City State ZIP Code
Phone (location #1)*
Hours of Operation (location #1)*
Will all of your locations have the same hours of operation on Thursday, October 27?*
# of tables at this location
# of visible staff members working at this location on 10/27/22*
We will provide event buttons for all of your visible staff members to wear on DOFM day; these can be passed from one shift to the next.
Contact for location #1 (manager/owner):
Address (location #2)*
Street Address Address Line 2 City State ZIP Code
Phone (location #2)*
Hours of Operation (location #2)*
# of tables at this location*
# of visible staff members working at this location on 10/27/22*
We will provide event buttons for all of your visible staff members to wear on DOFM day; these can be passed from one shift to the next.
Contact for location #2 (manager/owner):
Address (location #3)*
Street Address Address Line 2 City State ZIP Code
Phone (location #3)*
Hours of Operation (location #3)*
# of tables at this location*
# of visible staff members working at this location on 10/27/22*
We will provide event buttons for all of your visible staff members to wear on DOFM day; these can be passed from one shift to the next.
Contact for location #3 (manager/owner):
Address (location #4)*
Street Address Address Line 2 City State ZIP Code
Phone (location #4)*
Hours of Operation (location #4)*
# of tables at this location*
# of visible staff members working at this location on 10/27/22*
We will provide event buttons for all of your visible staff members to wear on DOFM day; these can be passed from one shift to the next.
Contact for location #4 (manager/owner):
Restaurant Information (5 Locations)
Address (location #1)*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone (location #1)*
Hours of Operation (location #1)*
Will all of your locations have the same hours of operation on Thursday, October 27?*
# of tables at this location*
# of visible staff members working at this location on 10/27/22*
We will provide event buttons for all of your visible staff members to wear on DOFM day; these can be passed from one shift to the next.
Contact for location #1 (manager/owner):
Address (location #2)*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone (location #2)*
Hours of Operation (location #2)*
# of tables at this location*
# of visible staff members working at this location on 10/27/22*
We will provide event buttons for all of your visible staff members to wear on DOFM day; these can be passed from one shift to the next.
Contact for location #2 (manager/owner):
Address (location #3)*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone (location #3)*
Hours of Operation (location #3)*
# of tables at this location*
# of visible staff members working at this location on 10/27/22*
We will provide event buttons for all of your visible staff members to wear on DOFM day; these can be passed from one shift to the next.
Contact for location #3 (manager/owner):
Address (location #4)*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone (location #4)*
Hours of Operation (location #4)*
# of tables at this location*
# of visible staff members working at this location on 10/27/22*
We will provide event buttons for all of your visible staff members to wear on DOFM day; these can be passed from one shift to the next.
Contact for location #4 (manager/owner):
Address (location #5)*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone (location #5)*
Hours of Operation (location #5)*
# of tables at this location*
# of visible staff members working at this location on 10/27/22*
We will provide event buttons for all of your visible staff members to wear on DOFM day; these can be passed from one shift to the next.
Contact for location #5 (manager/owner):
Restaurant Information (6 Locations)
Address (location #1)*
Street Address Address Line 2 City State ZIP Code
Phone (location #1)*
Hours of Operation (location #1)*
Will all of your locations have the same hours of operation on Thursday, October 27?*
# of tables at this location*
# of visible staff members working at this location on 10/27/22*
We will provide event buttons for all of your visible staff members to wear on DOFM day; these can be passed from one shift to the next.
Contact for location #1 (manager/owner):
Address (location #2)*
Street Address Address Line 2 City State ZIP Code
Phone (location #2)*
Hours of Operation (location #2)*
# of tables at this location*
# of visible staff members working at this location on 10/27/22*
We will provide event buttons for all of your visible staff members to wear on DOFM day; these can be passed from one shift to the next.
Contact for location #2 (manager/owner):
Address (location #3)*
Street Address Address Line 2 City State ZIP Code
Phone (location #3)*
Hours of Operation (location #3)*
# of tables at this location*
# of visible staff members working at this location on 10/27/22*
We will provide event buttons for all of your visible staff members to wear on DOFM day; these can be passed from one shift to the next.
Contact for location #3 (manager/owner):
Address (location #4)*
Street Address Address Line 2 City State ZIP Code
Phone (location #4)*
Hours of Operation (location #4)*
# of tables at this location*
# of visible staff members working at this location on 10/27/22*
We will provide event buttons for all of your visible staff members to wear on DOFM day.
Contact for location #4 (manager/owner):
Address (location #5)*
Street Address Address Line 2 City State ZIP Code
Phone (location #5)*
Hours of Operation (location #5)*
# of tables at this location*
# of visible staff members working at this location on 10/27/22*
We will provide event buttons for all of your visible staff members to wear on DOFM day; these can be passed from one shift to the next.
Contact for location #5 (manager/owner):
Address (location #6)*
Street Address Address Line 2 City State ZIP Code
Phone (location #6)*
Hours of Operation (location #6)*
# of tables at this location*
# of visible staff members working at this location on 10/27/22*
We will provide event buttons for all of your visible staff members to wear on DOFM day; these can be passed from one shift to the next.
Contact for location #6 (manager/owner):
Restaurant Locations (7 or more)
If you have six or more locations participating in DOFM 2022 please upload a list to include: address, phone number, # of tables and staff members at each location, and hours of operation on Thursday, Oct 27. Including a managers name for each restaurant would be helpful, as well.
Marketing Details
Are you allowed & willing to hang an outdoor banner promoting DOFM for the month of October?*
Would you prefer vertical or horizontal banner(s)?*
Please specify horizontal or vertical by location (ie Woodruff Rd - horizontal, Wade Hampton - vertical, Haywood Rd - horizontal, etc)*
Will you display the table tents that we provide?*
May we link to your website?*
What is your website address?
Can a road sign, promoting your restaurant as a DOFM participant, be placed at your location on 10/27/22?*
Can we set up an information table at your restaurant on 10/27/22?*
Our volunteers will be out at restaurants on DOFM day. We provide all the materials needed for our volunteers. The touch provides your patrons with an added opportunity to learn how your business is involved in the community by supporting a local non-profit.
Regarding your logo...*
If you have have participated in DOFM before and your logo has not changed then LTBM already has your logo from previous years. If you are a new restaurant partner, or if you have refreshed your logo, please submit a new one.
Restaurant Logo*
Drop files here or

Accepted file types: jpg, eps.
Agreement
Please put a check next to each box indicating your agreement and understanding.
20% of Entire Day's Sales (excluding alcohol)*
- The restaurant listed on this form, and all locations included above, will be donating 20% of total sales (including catering, delivery, dine-in, take-out, gift cards; excluding alcohol) made on Thursday, October 27, 2022, to Let There Be Mom by November 15, 2022.
Marketing Materials*
- In addition to other forms of media. LTBM will provide you with posters, table tents (if you indicated above that you will use them), and postcards that your staff will begin distributing to patrons on or around Thursday, October 7, 2022.
Gift Card Donation*
- Each participating restaurant location will be donating a "Meal for Two" gift card/certificate to LTBM by October 1. These gift cards will be awarded as a prize in a raffle. (value should be an estimate of what it will cost two people to dine at your location).
Signature

DOFM Restaurant Registration

Restaurant Information

Restaurant Information (2 locations)

Restaurant Information (3 locations)

Restaurant information (4 Locations)

Restaurant Information (5 Locations)

Restaurant Information (6 Locations)

Restaurant Locations (7 or more)

Marketing Details

Agreement

Our Sponsors

Let There Be Mom Corporate Sponsors

Let There Be Mom