Event Reservation Form

Contact Information

Title

*

First Name

*

Last Name

*

Address

*

City

*

State

*

Zip

*

Email

*

Attendee Information

For Membership or a Discount Code Text 516 983 8672

Guest Type	Number of Guests	Amount	Discount	Total
Men (Suggested Optional Payment)		99.00
Women (Suggested Optional Payment)		99.00
Boys (Ages 6-15)		18.00
Girls (Ages 6-15)		18.00
Young Kids 3-5 Holiday Crafts & Play		18.00
Total

Please enter all attendee names

	#	Guest Type	Guest First Name	Guest Last Name

Payment Information

Reservation Amount

*

Donation Amount

Total Amount

*

Card Number

*

Card Expiration

*

*

Security Code

*

Same as above

Name on Card

*

Billing Address

*

Zip Code

*