Culver City Chapter Monthly Mixer

Culver City Chapter Registration Form

VIRTUAL: ZOOM iNFO -- Will Be Sent
Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Terms & Conditions: Please be advised that all photographs, video and audio can and will be used for the Southern California Black Chamber of Commerce website, social media, marketing, and other outlets. By agreeing, you consent to allow us to use your images and likeness. You further agree that all money received by the chamber of commerce is nonrefundable.
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Culver City Chapter Registration Form