Online Event Registration

"*" indicates required fields

Name*

First Last

Organization

Address*

Street Address City State ZIP Code

Email*

Phone*

Names and Email Addresses of People Attending*

Dietary Restrictions of Attendees

Number of members being registered *

Price: $50.00

Number of non-members being registered *

Price: $70.00

Total

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Name

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P. O. Box 95, Fairfield, WA. 99012
(509) 495-4064

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