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Contact
Contact Details
Name
(Required)
First
Last
Email
(Required)
Phone
(Required)
Address
(Required)
Street Address
Address Line 2
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Ticket Selection
Individual Ticket
Quantity
Price:
$60.00
Quantity
Couple
Quantity
2 Tickets
Price:
$100.00
Quantity
Full Table
Quantity
10 Tickets
Price:
$500.00
Quantity
Attendee Names
(Required)
Please tell us the names of those attending the event so we can arrange the seating chart!
Total
Credit Card
Cardholder Name
Card Details