Name
*
First Name
Last Name
Company Name (if applicable)
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please note: We will need your cell phone on file to streamline registration
Texts you receive will be related to this event only, and your contact information will be kept securely per the latest security standards. Thank you for helping us provide you an enjoyable event experience!
Email
*
example@example.com
Cell phone number
*
Please enter a valid cell phone number.
How you'd like to be listed in the program? Deadline for program listing: April 20
*
Tickets, Sponsorships & Donations
Please Select
Regular ticket(s) ~ $125 each. Specify # below.
1 individual sponsorship ticket ~ $275
2 individual sponsorship tickets ~ $550
Feather in Your Hat sponsorship table ~ $1,750
Beret sponsorship table ~ $3,000
Bonnet sponsorship table ~ $5,000
Cloche sponsorship table ~ $10,000
Grand Chapeau sponsorship ~ $15,000
Top Hat Presenting sponsorship ~ $20,000
Tiara sponsorship ~ $25,000
Regular Tickets (if applicable)
Please Select
1 ticket ~ $125
2 tickets ~ $250
3 tickets ~ $375
4 tickets ~ $500
5 tickets ~ $625
6 tickets ~ $750
7 tickets ~ $875
8 tickets ~ $1,000
9 tickets ~ $1,125
10 tickets ~ $1,250
Total amount to be paid via PayPal from above.
*
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USD
Description
Donation only? (I will not attend luncheon.)
Yes
No. I am attending.
Names of Attending (Please list table guests, if applicable.)
*
Hats Off to Mothers Keepsake Book - New This Year!
Support a great cause with a great present for mom! Submit your ad by April 1
If you are purchasing a $275+ sponsorship, you receive complimentary ad space per the grid below! Would you like to use this benefit?
Yes (If yes, *after purchasing your sponsorship/tickets* go to lifeunlimitedinc.org/hotm-book for all info and to submit your ad. See benefit grid below and click on it to access the webpage.)
No
Payment Methods
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please click one of the PayPal options to complete payment and
submit
the form.
Submit
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