Ultimate Date Night - Registration
Registration form for Feb 11 2017 Ultimate Date Night, couples dinner
* Required
Last Name
*
What is your last name?
Your answer
First Name
*
Your answer
If you have any allergies / dietary restrictions, please elaborate.
Gluten-free
Other:
Spouse's First Name
*
Your answer
Spouse's Last Name
*
This event is for couples - single tickets are not available.
Your answer
If your spouse has any allergies / dietary restrictions, please elaborate.
Gluten-free
Other:
E-mail address
*
Your answer
Method of Payment - choose either:
*
$35 Cheque (pay at door)
$35 E-Transfer
Phone Number
*
Your answer
How did you hear about the Ultimate Date Night?
Attended previous Sanctifying Families / Ultimate Date Night event
Friday Facts
Word of Mouth
Facebook
Parish Bulletin (please indicate which parish in "other")
Other:
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