Eliza Hope Splash Day RSVP Page for The Eliza Hope Foundation

Contact information

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Last name Last name

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Phone Phone

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Phone type Phone type

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Address

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Apartment, suite, etc. (optional) Apartment, suite, etc. (optional)

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State State

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ZIP code ZIP code

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Additional details

One registration per family! Please list the total number of children attending under your registration name:

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Please list the age of each child:

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Registration fee

A registration fee is required to participate

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$20

Splash Day Registration

One registration per family! Thank you.

Payment

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Cardholder name Cardholder name

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Account holder name Account holder name

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Bank name

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I happily agree to cover the fees so that 100% of the amount goes to The Eliza Hope Foundation

Billing address

Same as donor address

Address Address

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Apartment, suite, etc. (optional) Apartment, suite, etc. (optional)

City City

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Country/region Country/region

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State State

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ZIP code ZIP code

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