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Bash Registration

Event will be held at the Antioch VFW on Saturday, April 15, 2023, from 6pm - 11pm.
Name(Required)
How would you like to register?(Required)
Which table package would you like to purchase?
Please enter a number from 1 to 8.
Person 1
Person 2(Required)
Person 3(Required)
Person 4(Required)
Person 5(Required)
Person 6(Required)
Person 7(Required)
Person 8(Required)
Price: $0.00
How would you like to make your registration payment?(Required)
During check-out, payment must be made with credit card.
Address
Credit Card Payment Information
American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Expiration Date
 

If mailing a check, please submit the form and then mail your check to:

The Butterfly Effect of Maddox J. LoPriore Foundation
P.O. Box 265
Lake Villa, IL 60046
(This address will also be emailed to you after your submission).
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