MOPAC Event Registration
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What event would you like to attend? *
List the names of all guests attending. *
List the names of all guests attending. Separate each name with a comma. Example "John Smith, Mary Johnson"
Write your email address and the email address of your guests.
 Separate each email address with a comma. Example "john43@gmail.com, susan_jones@yahoo.com" *
Voucher Company--Amazon Local, Living Social, Google Offers) *
Enter all your voucher number(s). Separate each voucher number with a comma. Example "1234567, 987654." DO NOT ENTER GROUPON VOUCHER NUMBERS HERE. If you HAVE a GROUPON voucher number write "NONE" here.
If you purchased a voucher with Groupon, you MUST print out your voucher and enter the numbers below the barcode. The barcode is at the bottom of the voucher. IF YOU DO NOT  ENTER THE CODE AT THE BOTTOM OF THE VOUCHER YOUR RESERVATION WILL NOT GO THROUGH. Write "NONE" if you do not have a GROUPON voucher.
How old are you? *
Enter your cell phone number so we can send you a text reminder the day of the event *
Enter your cell phone number so we can send you a text reminder the day of the event
I agree to conduct myself in an appropriate manner during the event. I will not engage in risky behavior or hold Wallen Blake Media Inc. liable if I harm myself during the event. *
Required
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