2019 CCDI Trivia Night Fundraiser
Event Date: Friday, November 1, 2019
Doors Open: 7:00 pm -- Event Begins: 7:30 pm
Event Address: St. Ann Community Center, 1 Community Center Drive, St Ann, MO 63074
Contact for Additional Information:
Christine Fallon at
Rachel Boemer at
**Please Note: The music is NOT Halloween themed music**
Team Captains Name (first and last)
Cell Phone Number
Team Name (if undecided, leave blank & your team name will be your captain's name)
Payment can be made (in full) via:
$200.00 - Cash (deliver to Rachel Boemer)
$200.00 - Check (make checks payable to CCDI)
$200.00 - Paypal (
Optional: Are you interested in being an event sponsor?
Yes, information will be sent to the email address listed on this form
Maybe, please email me additional information
Optional: Are you interested in donating a raffle basket item? (promotional company/business logo baskets, tickets to an event, gift cards, etc)
Maybe, please contact me before the event
Optional: Would you like to make an additional monetary donation to CCDI? (If yes, please list amount below)
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