2026 DOFL Host Ambassador Agreement Form

Dining Out For Life - April 30, 2026

RESTAURANT HOST AMBASSADOR AGREEMENT FORM
Host Name*

First NameLast Name
Host Email*
example@example.com
Host Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
YesNo
If yes, what is the name of your group/organization?
YesNo
12 SouthAntiochBelle MeadeBellevueBelmont/HillsboroBerry Hill/Melrose/100 OaksBrentwoodClarksvilleCool SpringsDonelsonDowntownEast NashvilleFranklinGallatinGermantownGreen HillsThe GulchHendersonvilleHermitage/Mt JulietLenox VillageMadisonMidtownMurfreesboroMusic Row/EdgehillThe NationsNorth NashvilleOpry MillsSouth NashvilleSylvan ParkWedgewood-HoustonWest EndWest Nashville/White BridgeWoodbineOther
12 SouthAntiochBelle MeadeBellevueBelmont/HillsboroBerry Hill/Melrose/100 OaksBrentwoodClarksvilleCool SpringsDonelsonDowntownEast NashvilleFranklinGallatinGermantownGreen HillsThe GulchHendersonvilleHermitage/Mt JulietLenox VillageMadisonMidtownMurfreesboroMusic Row/EdgehillThe NationsNorth NashvilleOpry MillsSouth NashvilleSylvan ParkWedgewood-HoustonWest EndWest Nashville/White BridgeWoodbineOther
12 SouthAntiochBelle MeadeBellevueBelmont/HillsboroBerry Hill/Melrose/100 OaksBrentwoodClarksvilleCool SpringsDonelsonDowntownEast NashvilleFranklinGallatinGermantownGreen HillsThe GulchHendersonvilleHermitage/Mt JulietLenox VillageMadisonMidtownMurfreesboroMusic Row/EdgehillThe NationsNorth NashvilleOpry MillsSouth NashvilleSylvan ParkWedgewood-HoustonWest EndWest Nashville/White BridgeWoodbineOther
BreakfastBrunchLunchDinner
YesNo
If yes, which restaurant?
Do you have a contact there? If so, list below.
Restaurant Location
Date*

MonthDayYear
Date
By typing my name below, I agree to uphold the commitment requirements as stated in the Host Ambassador Expectations packet provided by Nashville CARES.*
Should be Empty:

Dining Out For Life - April 30, 2026