Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Attendance *

Will you attend the event in person?

I will be there

I can't attend, but might watch the Livestream

Split or Go All the Way

Split

Go All the Way

Method of Payment

Zelle (Preferred)

PayPal

Check via Mail

Check Drop Off at House

Cash Drop Off at House