Inspired Hands Dinner Registration
Sunday, October 25th at 6:30pm | Ministry Partner Fair 4-6pm (come & go), followed by a 6:30pm dinner from Inspired Hands
Name
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Email
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Phone
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Do you (or anyone in your party) have food allergies or dietary restrictions?
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Please select one option.
No
Yes
If yes, please list them:
Childcare will be provided. If you are planning to use childcare, please let us know how many children and their ages, so we can plan accordingly.
Payment
1 ticket ($18.00)
2 tickets ($36.00)
3 tickets ($54.00)
4 tickets ($72.00)
5 tickets ($90.00)
6 tickets ($108.00)
1 ticket ($18.00)
2 tickets ($36.00)
3 tickets ($54.00)
4 tickets ($72.00)
5 tickets ($90.00)
6 tickets ($108.00)
Amount
Credit/Debit Card Number
Expiration Date/CVC
Name on Card
Card Billing Address
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Submit
Description
Sunday, October 25th at 6:30pm
Ministry Partner Fair 4-6pm (come & go), followed by a 6:30pm dinner from Inspired Hands
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