A Drink and a Laugh Registration

1Contact Information

2Tickets

3Sponsor

4Sponsor Details

5Donations

Name*
First Last
Company Name
Address*
Street Address 1 Street Addres 2 City State ZIP Code
Email*
Enter Email Confirm Email
Phone*
My phone is a*
- Home Phone
- Business Phone
- Mobile Phone
How did you hear about the center?
Would you like to Include a note with your registration?
- Yes, Include a note.
Additional Notes for the Center (Optional)
I would like to:*
- Purchase Tickets
- Become a Sponsor
- Make a Donation
Sponsorships includes Tickets

I would like to donate the following amount:
Enter amount here*
Total
$0.00
Total includes Tickets, Sponsorship, and Donations.
Additional Sponsor Information
- This gift should be listed as anonymous
- This is a tribute gift
Is this in honor or in memory of a person or occasion?*
Name of person and/or description of occasion being commemorated*
Notify Tribute
- Please send a letter of acknowledgement to the person(s) or family listed here at the address below. Your donation amount will not be disclosed.
Name*
First Last
Address*
Street Address 1 Street Address 2 City State ZIP Code
Note to be included with the acknowledgement (optional)
Employer Match
- My employer will match my gift
You may be eligible to double or triple your gift to the Center through your company’s matching gift program. Please contact your Human Resources representative to find out if your company has a matching gift program.
Employer Name*
Employer Phone*
Employer Email*
Employer Address*
Street Address 1 Street Address 2 City State ZIP Code
Additional Notes or Questions about Donations? (Optional)
Name
This field is for validation purposes and should be left unchanged.

98743

First Name	Last Name	Email Address	Phone	Ticket Holder is age 21 or older? Yes/No	Pavilions Location - Burbank, Sherman Oaks, West Hills, N/A

First Name	Last Name	Email Address	Phone	Ticket Holder is age 21 or older? Yes/No	Pavilions Location - Burbank, Sherman Oaks, West Hills, N/A

Purchase Tickets