Dating With The Stars Registration Form
Canopy Hilton (Treehouse)
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Zodiac Sign
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♈ Aries (Ram): March 21–April 19
♉ Taurus (Bull): April 20–May 20
♊ Gemini (Twins): May 21–June 21
♋ Cancer (Crab): June 22–July 22
♌ Leo (Lion): July 23–August 22
♍ Virgo (Virgin): August 23–September 22
♎ Libra (Balance): September 23–October 23
♏ Scorpius (Scorpion): October 24–November 21
♐ Sagittarius (Archer): November 22–December 21
♑ Capricornus (Goat): December 22–January 19
♒ Aquarius (Water Bearer): January 20–February 18
♓ Pisces (Fish): February 19–March 2097
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Format: (000) 000-0000.
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-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Age
*
This Event is for ages 24-41
This Event Is for ages 24-41
This Event Is full for Ladies! But feel free to come enjoy a drink and vibe to some Old-School R&B. Want us to keep in touch?
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Dating With The Stars Registration Form ****Friend****
Full Name
*
First Name
Last Name
Gender
*
Please Select
Female
Male
Zodiac Sign
*
Please Select
♈ Aries (Ram): March 21–April 19
♉ Taurus (Bull): April 20–May 20
♊ Gemini (Twins): May 21–June 21
♋ Cancer (Crab): June 22–July 22
♌ Leo (Lion): July 23–August 22
♍ Virgo (Virgin): August 23–September 22
♎ Libra (Balance): September 23–October 23
♏ Scorpius (Scorpion): October 24–November 21
♐ Sagittarius (Archer): November 22–December 21
♑ Capricornus (Goat): December 22–January 19
♒ Aquarius (Water Bearer): January 20–February 18
♓ Pisces (Fish): February 19–March 2097
Ethnicity
*
Please Select
Hispanic
White/Caucasian
Black
Two or more races
Age
*
This Event is for ages 24-41
File Upload
Browse Files
Drag and drop files here
Choose a file
You do not have to click "Save"
Cancel
of
Phone Number
*
Format: (000) 000-0000.
E-mail
*
example@example.com
Birthday
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Social Media
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Have over 10k followers?
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Dating With The Stars (Saturday Feb 14th 7pm-9pm) Early Bird****
Male Ticket
$20.00
$
20.00
Quantity
1
2
Dating With The Stars (Saturday Feb 14th 7pm-9pm) Early Bird****
Female Ticket
$20.00
$
20.00
Quantity
1
2
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