June 24th, 6 PM -7 PM
Pleasant Hill, CA
Name
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First Name
Last Name
Email
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example@example.com
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
May we contact you via text message?
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Date of Birth (this allows us to text you via our HIPAA-compliant texting service for event reminders)
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Day
Year
Date
Are you bringing anyone with you?
Yes
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How many friends are you bringing with you?
How did you hear about this event?
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