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Shallotte Rotary Club
Las Vegas Night
January 25, 2014
6:00 pm until 10:30 pm
101 Stone Chimney Place
PLEASE BRING THIS FORM WITH YOU THE NIGHT OF THE EVENT TO PICK-UP YOUR TICKETS!
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Your Information
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Address 2
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Is this your first Las Vegas Night with Shallotte Rotary Club?
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. I understand that I may receive emails regarding this event and other relevant information, and can opt out at any time.
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Your Partner/Guest Information
First Name
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Last Name
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Email
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Preferred Phone
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Address 1
:
Address 2
:
City
:
Zip/Postal Code
:
State/Province
:
Is this your first Las Vegas Night with Shallotte Rotary Club?
:
Yes
No
I consent to the collection, storage, and use of my information by Rotary Club of Shallotte as described in this
Privacy Policy
. I understand that I may receive emails regarding this event and other relevant information, and can opt out at any time.
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