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2021 Gala
Thursday, November 4, 2021, 6-9 p.m.
Register for the Uptown Hoedown
"
*
" indicates required fields
Name
*
First
Last
Email
*
Phone
*
Address
*
Street Address
City
State / Province / Region
ZIP / Postal Code
Ticket Information
Tickets Cost $30/person
*
Price:
How many tickets would you like to purchase?
*
Please enter a number from
1
to
100
.
Hidden
Please enter your shirt sizes for each registrant
Payment Details
Coupon
Total
Credit Card
Cardholder Name
Card Details