Dinner Registration

Enjoy a great dinner and a memorable evening with friends.

Your Information

First Name

Last Name

Email Address

Phone Number

Address

City

State

Zip

Dinner {[{$index + 1}]}

First Name

Last Name

Other Team Members

{[{joinTeam.fname}]} {[{joinTeam.lname}]}

Make a Donation

In addition to the dinner registration, would you like to make a one time donation to the Karl R. Potach Foundation?

$0

$10

$25

$50

Thank You

Your registration for the dinner has been completed.

Registration

{[{registrantName($index)}]}
- $35 Dinner Program
Additional
- ${[{regData.donation}]} Tax Deductible Donation

${[{totalCost()}]} Total