St. George Road Trips - Starbright - December 4, 2019 Each person purchasing a ticket must complete this online form for each trip. This helps us in keeping track of our registrations and payments. PARTICIPANT INFORMATION FIRST NAME * LAST NAME * ADDRESS ADDRESS Mailing Address, Street number and name Mailing Address, Street number and name Apartment/Lot/Unit # Apartment/Lot/Unit # City City State/Province State/Province Zip/Postal Zip/Postal PHONE NUMBER * E-MAIL Confirm E-MAIL Please confirm email address DIETARY RESTRICTIONS Any allergies or restrictions that you may have EMERGENCY CONTACT INFORMATION In the event of an emergency we need to be able to contact a family member or friend. FIRST NAME * LAST NAME * PHONE NUMBER * TRIP REGISTRATION PAYMENT WILL BE MADE BY: * Paypal Payment with Credit card (will be sent to site after clicking submit) Credit Card at the Parish Office Cheque (make them payable to ST. GEORGE PARISH) Cash (dropped off at the parish office) reCAPTCHA Lookup Submit If you are human, leave this field blank.
