IMCSTL Annual Diwali Gala 2024 Registration

October 26th, 2024

Name*
First Last
Email*
Phone*
Address*
Street Address Address Line 2 City State ZIP Code
Are you?*
- Member
- Non-Member
Who is attending the Diwali Gala 2024*
- Self
- Spouse
- Not Attending
Member Fee*
Price:
Non-Member Fee*
Price:
Quantity*
Please enter a number from 1 to 10.
Spouse Fee*
Price:
Quantity*
Please enter a number from 1 to 1.
Spouse Fee*
Price:
Quantity*
Please enter a number from 1 to 1.
Kids Babysitting*
Price:
Quantity*
Please enter a number from 0 to 5.
Table (Ten Seats)*
Price:
Quantity*
Please enter a number from 0 to 1.
Are you bringing any Non-member Guests?
- Yes
- No
Registered Non-Members/Guests*
Price: $50.00
Are you bringing any Guests?
- Yes
- No
Registered Guests*
Price: $50.00
Guest Information*
First Name Last Name

Click on (+) to add another guest.
Total
$0.00
Please Note: After you Submit this form, you will be directed to PayPal page to complete payment information. Your registration will not be complete without completing payment on PayPal. If you do not have PayPal just continue as guest and you will be able to pay directly with your credit card. Thank You.
Email
This field is for validation purposes and should be left unchanged.

First Name	Last Name