Event Registration

Channel Islands Republican Women » Event Registration

Contact Details

Name(Required)

First Last

Email(Required)

Phone

How did you hear about this event?

Event Details

Select Event(Required)

Your Meal Choice(Required)

Bring a guest - Excluding your entry(Required)

Number of guests(Required)

Guest Name(Required)

First Last

Guest Meal Choice(Required)

2nd Guest Name(Required)

First Last

2nd Guest Meal Choice(Required)

3rd Guest Name(Required)

First Last

3rd Guest Meal Choice(Required)

4th Guest Name(Required)

First Last

4th Guest Meal Choice(Required)

5th Guest Name(Required)

First Last

5th Guest Meal Choice(Required)

6th Guest Name(Required)

First Last

6th Guest Meal Choice(Required)

7th Guest Name(Required)

First Last

7th Guest Meal Choice(Required)

8th Guest Name(Required)

First Last

8th Guest Meal Choice(Required)

9th Guest Name(Required)

First Last

9th Guest Meal Choice(Required)

10th Guest Name(Required)

First Last

10th Guest Meal Choice(Required)

Payment Details

Total

Pay By(Required)

Square

Zelle

Check

Credit Card(Required)

Configuration Required: To use the Square field, please configure your Square Settings.

Zelle Payment Transaction No.(Required)

Zelle Payment Receipt Upload(Required)

Accepted file types: png, gif, jpg, jpegdoc, docx, pdf, Max. file size: 64 MB.

Please pay online through Zelle and enter Transaction Number and Receipt of Zelle Payment. Zelle Email: barbararoy22@yahoo.com

Please pay with your check at the door. Thank you!