Joint Spouses' Luncheon Registration Form

Joint Spouses' Luncheon Registration

Please register by filling out the below form.
Full Name*

First NameLast Name
E-mail*
example@example.com
Phone Number*
Number of people attending*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you have specific questions or topics you'd like for our keynote speaker, Dr. Monica Reintjes, PhD & Licensed Professional Counselor to address?
My Products
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Luncheon Registration
(We have lowered the price to make it for affordable for everyone to $25.)

$25.00 Quantity



Childcare Pass Needed
Please add how many children arriving to event for childcare provided in adjacent room from event.

$ Free



How many children requiring childcare?
$ Free Quantity



Total

$0.00
Dietary Preferences
Which armed service is your spouse?
If using childcare at the luncheon, what are your children's ages?
Do you need to meet with a LSC board member in person to pay in the form of cash or check? Checks should be payable to Langley Spouses Club. If so, write yes and a LSC board member will email you to coordinate a time to meet in person.
Payment Methods

Choose from one of the PayPal options to make your payment.
Should be Empty: