12 Steps in 12 Hours - Portland Registration Form
June 14-15, 2024
Name
*
First Name
Last Initial
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Gender
Female
Male
Dietary Restriction
*
Vegetarian
Gluten-free
Vegan
Standard
Other
Wiling to carpool
Yes
From What Area will be carpooling from
Room #
Date
*
-
Year
-
Month
Day
Date
Hour Minutes
AM
PM
AM/PM Option
Payments are processed through Square. We do not store the Payment card or address information.
My Products
prev
next
( X )
Friday & Saturday w/Lunch
$
25.00
Credit Card
Register
qr code Calculation value
You qr code will be emailed to you once you click register, This can be used for Checkin at the event.
Should be Empty: