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2022 Champions for Change Gala- Ticket Purchase

**Because our event takes place at Crisler Center on the University of Michigan campus, we will be following all health and safety protocols required by the university at the time of the event. The current UM rule is that all attendees must show either proof of vaccination or a negative PCR from a medical provider taken within 72 hours of the event.**

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Contact Information for Purchaser
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First Name
Last Name
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
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Contact Information for Additional Attendees
Please enter unique phone/email information for all attendees so that we can communicate event details directly via email and text.
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First Name
Last Name

Please enter email address of attendee, not the email address of registrant

Please enter phone number of attendee, not the phone number of registrant
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First Name
Last Name

Please enter email address of attendee, not the email address of registrant

Please enter phone number of attendee, not the phone number of registrant
*

*

First Name
Last Name

Please enter email address of attendee, not the email address of registrant

Please enter phone number of attendee, not the phone number of registrant
*

*

First Name
Last Name

Please enter email address of attendee, not the email address of registrant

Please enter phone number of attendee, not the phone number of registrant
*

*

First Name
Last Name

Please enter email address of attendee, not the email address of registrant

Please enter phone number of attendee, not the phone number of registrant
*