inSIGHT OUT 2024-2025 Registration Form

First Name*

Last Name*

Email*

example@example.com

Phone*

Address*

Street Address

Street Address Line 2

CityState

Zip Code

How did you hear about this event:

What would you like to register for?*

All day event (includes luncheon, boutique and card play)Attend luncheon & boutiqueBoutique only

Please select your preferred pricing option*

Per person: $250Table of 10: $2500 note: we will contact you after you register to get the names of individuals at your lunch table. Tables are ideally for 10.

Number of people who you would like to register for the luncheon and boutique:*

If this number is greater than 6 we will contact you directly to obtain the information for your additional guests.

Game you will play:*

CanastaMah JonggBridge

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 - 6 players

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

Please list the other players at your card table (player 5 and 6 are optional):*

	Player 2	Player 3	Player 4	Player 5	Player 6
First Name
Last Name
Email
Cell Phone

Please list the names of your guests (guests 2-5 are optional):*

	Guest 1	Guest 2	Guest 3	Guest 4	Guest 5
First Name
Last Name
Email
Cell Phone

My payment covers (check all that apply):*

Please indicate the meal preference of your paid guests (guests 3-6 are optional):*

	Guest 2	Guest 3	Guest 4	Guest 5	Guest 6
Meal Choice

Cards Amount

Table 1

Please list the other players at your table:*

	Player 2
First Name
Last Name
Email
Cell Phone

My payment covers:*

Player 1 (You) $250Players 1 & 2 $500

Note: Registration is not required for individuals whose expenses have been covered by you. All other participants at your table must register individually.*

I understand

Total Amount to be Paid Calculation:

Total Amount Deductible Calculation - by seat:

Total Amount Goods/Services by seat:

Total Amount Deductible

If you would like to add a donation please indicate the amount here. Annual donors of $2,500+* are invited to a pre-reception with Lizzy and Tanya from 10:30am-11:30am.

* donors who have made a donation or pledge of $2,500+ between July 1, 2024 and June 30, 2025.

amount to be paid by credit card

Total Amount to be Paid before donation

Total Amount to be Paid

Total Amount to be Paid old

Payment Method:*

Credit CardCheck

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

For luncheon, please indicate the names of any of your paid guests that prefer a vegetarian option. *

Do you have any seating preferences or dietary restrictions for lunch? Let us know—we would love to accommodate you!

or call Lauren Slutsky 561-570-2656 Ext. 0

If paying by check:

Please make check payable to inSIGHT Through Education, Inc.
On the memo line please indicate "inSIGHT OUT"

Please mail your check to:

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

Payment Amount:

USD

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Date

For assistance with this form please contact:

lauren@insightthrougheducation.org 561-570-2656 EXT.0

A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE 1-800-435-7352, OR BY VISITING WWW.FDACS.GOV. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL OR RECOMMENDATION BY THE STATE. FL REGISTRATION #CH34845 | EIN:27-3388434