The Candle Lighters · 2023 BREWS FOR BUDDIES

REGISTRATION

NAME

*

First Name

Last Name

ADDRESS

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

EMAIL

*

Verify Email

*

PHONE#

REGISTRATION	Quantity
$50 - Per Ticket

I AM UNABLE TO ATTEND, PLEASE ACCEPT MY DONATION

$

WISH LIST DONATION

$

WISH LIST CHOICE

*

Scholarship for Early Intervention infants and toddlers

Transportation to Camp Hope for families in need and Stepping Stones field trips

General donation for educational games, playground equipment, and field-trips for the students, technology equipment and software for students, and toys to assist learning for the infants and toddlers in Early Intervention Program

Guest #2

*

First Name

Last Name

Guest #3

*

First Name

Last Name

Guest #4

*

First Name

Last Name

Guest #5

*

First Name

Last Name

Guest #6

*

First Name

Last Name

Guest #7

*

First Name

Last Name

Guest #8

*

First Name

Last Name

Guest #9

*

First Name

Last Name

Guest #10

*

First Name

Last Name

IMPORTANT NOTE:

**** PLEASE SCROLL UP ON THE NEXT PAGE AFTER YOU SELECT "ENTER PAYMENT INFORMATION" TO GET YOUR PAYMENT OPTIONS ****