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Pasta Dinner Registration
May 31, 2014 - Suicide Six Lodge

The form is self-calculating.
Enter your quantities and click "Total".
Do not use "Enter" or the form will submit prematurely.

5PM     7PM

Name: 
Address 1: 
Address 2: 
City: 
State: 
Zip: 
Phone: 
E-mail: 

Adults at $18 each $
Children at $10 each $
 
TOTAL  $

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Expiration Date: 

Cards are charged upon receipt.
No refunds after May 1, 2014

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We look forward to welcoming you on May 31, 2014!