Health Innovation Holiday Celebration Event Registration + Optional Donation
December 5, 2024 - 5:00 PM | Pegasus Park - 13th Floor
Attendee Information
Please fill out the registration form below.
Your Name
*
First Name
Last Name
Email Address
*
example@example.com
Company Name
*
OPTIONAL DONATION - Co-organizers will be recognized on the invitation | All proceeds will be donated to a charity via the Rotary Club of Dallas Foundation - Not required for registration.
prev
next
( X )
General Donation
$
10.00
Quantity
1
2
3
4
5
6
7
8
9
10
Spread the Cheer
$
50.00
Quantity
1
2
3
4
5
6
7
8
9
10
Silver Donation
$
100.00
Quantity
1
2
3
4
5
6
7
8
9
10
Gold Donation
$
250.00
Quantity
1
2
3
4
5
6
7
8
9
10
Platinum Donation
$
500.00
Quantity
1
2
3
4
5
6
7
8
9
10
Email jovelyn@healthwildcatters.com to be a co-organizer
$
1,000.00
Quantity
1
2
3
4
5
6
7
8
9
10
Payment Methods
Debit or Credit Card
Please click one of the PayPal options to complete payment and
submit
the form.
Submit
Should be Empty: