Palm Springs Mixer Registration

Palm Springs Chapter Registration Form
Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
Will you be bowling?

yesno
If yes, what size shoe are you?
Registration type
prevnext( X )
Mixer Registration for Non -Members$25.00

Quantity

Mixer Registration for current SCBCOC members$20.00

Quantity

Vendor Space- Current Member$20.00

Vendor Space - Non- Member$25.00

Total $0.00
I agree to {terms & conditions}.*
Should be Empty: