All White Affair Registration

Kickin' It Up For Positivity Affair Registration Form
The Bank Event Center

3120 Donald E. Hollowell Parkway Atlanta, GA 30318 6-10pm
Name*

First NameMiddle NameLast NameSuffix
Birth Date

MonthDayYear
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
example@example.com
Phone Number
Format: (000) 000-0000.
If purchasing for multiple, please include all names and update quantitity below

Payment*

Kickin' It For Positivity Registration

Registration for the Kickin' It Up For Positivity Affair fundraising event. *Remember, your payment is tax deductible!

$60.00 Quantity

Total

$0.00

Credit Card

Apple Pay

Google Pay

Cash App Pay

Kickin' It Up For Positivity Affair Registration Form