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Angels Tickets Request
Sickle Cell Disease Community Event - Tuesday, April 21st
Only SCDF-registered clients are eligible to receive complimentary Angels baseball game tickets. If you are not currently registered, you will need to complete the SCDF client registration process. After completing this ticket form, a registration link will be emailed to you, and SCDF will follow up once your submission is received.
*
I understand
Name of individual with sickle cell disease:
*
First Name
Last Name
Current SCDF Client?
*
Please Select
Yes
No
Unsure
If No, or Unsure, you will receive a link to register as a SCDF Client.
Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Type of Sickle Cell Disease
Please Select
Sickle Cell Anemia (Hgb SS)
Sickle Cell C Disease (Hgb SC)
Sickle Cell D Disease (Hgb SD)
Sickle Beta Thalassemia
Other
Name of Physician or Nurse:
First Name
Last Name
Physician or Nurse's Phone Number:
Format: (000) 000-0000.
Ticket Distribution:
Name of person completing form:
*
First Name
Last Name
Relationship to person with sickle cell disease:
*
Please Select
Self
Mother
Father
Husband
Wife
Grandmother
Grandfather
Brother
Sister
Aunt
Uncle
Guardian
Other
Your Phone Number:
*
Format: (000) 000-0000.
Texts Accepted:
*
Please Select
Yes
No
Email:
*
example@example.com
Number of people living in the home?
*
Number of Angels tickets requested. We are offering 4 tickets but may be able to provide more.
Number of Angels tickets requested. We are offering 4 tickets but may be able to provide more depending on the number of responses we receive.
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Angels Game Tickets
$
Free
Quantity
1
2
3
4
If you need more than 4, please enter how many ADDITIONAL tickets you need: (We will try our best to accommodate, but it is not guaranteed).
This number is on top of the 4 tickets selected above. Please do not include the 4 tickets selected.
Ticket Distribution:
*
Please Select
Mail to my address above (regular first class mail)
Pick Up - Ontario (SCDF) - select date/time below
Pick Up - Orange (CIBD) - select date/time below
Ontario Ticket Pick Up - If ticket pick up is preferred, please select your appointment below: (SCDF Office Ontario, CA Only)
Orange/CIBD Ticket Pick Up - If ticket pick up is preferred, please select your appointment below for the Center For Inherited Blood Disorders - CIBD (Orange, CA)
Please note, Angel Stadium is a cashless venue. Please come prepared with a credit card for any game day purchases including parking, food & beverage, or merchandise.
*
I understand
Baseball Regular Season day-of-game parking prices are as follows: $25 for general parking when purchased in-person ($27 when purchased online), $35 for preferred parking when purchased in-person ($37 when purchased online; subject to availability).
*
I understand
Application will be submitted when you hit the red submit button below:
*
I understand
Submit
For office use only:
SCDF Follow up
Comments/Notes:
Should be Empty: