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The Perky Wallflower Speed Dating Sign Up
Welcome to speed dating!  Fill out the form below to join our event.  Registration and payment of $25 is required at least 24 hours before the event through Venmo @theperkywallflower (last 4 digits of the phone number are 8277).  You will be paired with partners of the opposite sex.  Number of dates varies for each event.  No refunds.  We look forward to helping you find your special someone. 
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What is your first and last name? *
What is your email address? *
What is your gender?
 *
How old are you? *
Which event would you like to attend?   *
How did you hear about us? (For example: flyer at Roos Roast, Meetup, friend/family, previous participant, Google search, etc.)
 *
Is there anything else you would like us to know about you?
What is your venmo transaction/payment ID number? This event requires prepayment of $25.  Venmo payment must be made before submitting this form to @theperkywallflower.  The last 4 digits of the phone number are 8277.  No refunds. *
By submitting this form you understand that you are signing up for an event that involves meeting people in public and that inherent health and social risks are involved.  You also understand that there are no refunds. Once you submit this form, you will be sent an email the week of the event with more specific information. *
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