FC Card Party 2024

Prefix*

First Name*

Last Name*

Email*

example@example.com

Phone*

Address

Street Address

Street Address Line 2

CityState

Zip Code

Game you will play:*

CanastaBridgeMah Jongg

Do you have a partner and want us to pair you? Let us know and we will help!*

I am a single and would like you to pair meI have a partner and would like you to pair usI have my table of 4 - 5 players

Note: If you have multiple tables please submit multiple forms.

Please list the other players at your table (player 5 is optional):*

My payment covers (check all that apply):*

Table 1

Cards Amount (a)

Please list the other players at your table:*

My payment covers:*

Player 1 (YOU) $175Players 1 & 2 $350

Total Amount to be Paid Calculation:

Total Amount Deductible Calculation:

Total Amount Goods/Services:

Total Amount to be Paid

Payment Method:*

Credit CardCheck

NOTE: We ask that all payments for your table be received within 7 days of submitting this reservation form.

Any special requests, comments or questions?

or call Linda Eigner 917-579-7589

If paying by check:

Please make check payable to inSIGHT Through Education, Inc.
On the memo line please indicate Frenchman's Card Party

Please mail your check to:

inSIGHT Through Education, Inc.
P. O. Box 33054
Palm Beach Gardens, FL 33420

For assistance with this form please contact:

info@insightthrougheducation.org — 561-570-2656 EXT.0

Payment Amount:

USD

Date