Event Registration - Online Event Solutions

Registration for The Silver and Turquoise Ball benefiting PIC

Cost per seat: $200.00

Primary Registrant

* Required Fields

First Name:*
Last Name:*

Meal Choice:

Street Address:*
Address 2:

City:*
State:
Zip Code:*

Home Phone:
Cell Phone:

Email Address:*

Referred By:

Please enter any comments or special seating requests:

(Your request will be forwarded to the Table Committee for review. While we would like to honor all individual seating requests, please understand that in some cases it will not be possible.)

Additional Attendees If you know your Guests' names at this time, please complete the boxes below and they will check in at registration under their name. If you do not know your Guests' names at this time, please enter GUEST for their first name and YOUR last name. They will then check in under your name at registration.

To update your guest list at any time, please contact the organization.

Spouse First Name:

Spouse Last Name:

Spouse Meal Choice:

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