St. Barnabas Charities 2018 Ladies' Day Out Registration

Saturday, October 20, 2018
Tavern 86 & Vines Wine Bar 
530 Northpointe Circle
Seven Fields, PA 16046

11 a.m. - 2:30 p.m.
724-625-3770
Name:

*
Address *
City: *
State: *
Zip: *
Email: *
Phone: *


Entry Tickets

Package 1: $80/person

Package 2: $100/person package - includes 1 extra chance to win the raffle prizes announced
every 30 minutes. A $5,000 value.

Tickets:
Quantity:

St. Barnabas Charities will contact you for the names of your guests for parties of more than 7.
Attendee 1   Attendee 2  
Name: Name:
Address: Address:
Email: Email:
Phone: Phone:
Attendee 3   Attendee 4  
Name: Name:
Address: Address:
Email: Email:
Phone: Phone:
Attendee 5   Attendee 6  
Name: Name:
Address: Address:
Email: Email:
Phone: Phone:
Attendee 7      
Name:    
Address:    
Email:    
Phone:    

50/50 Raffle - 5 tickets for $10, 15 tickets for $20, 30 tickets for $30
Quantity:

Basket Raffle - 5 tickets for $10, 15 tickets for $20, 40 tickets for $40
Quantity:

Program Advertisements:
   
Name on card:

  *

Card Type: *
Card Number: *
Expiration Date* /
V-Code: *

Optional donation (separate from entry fee): $

How did you hear about this event?


* Indicates mandatory information is required to submit.

TOTAL COST: $
0.00