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| Ticket Prices (Golf and Tennis tickets include all day dining, reception, and dinner) |
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Golf Foursome: $2,750 |
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Golf Individual: $750 |
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Tennis: $400 |
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Reception / Dinner Only: $250 per person |
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Corporate Table of 10 guests: $2,500 |
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| Please check all that apply |
Tennis
Golf
Reception and dinner only |
Number of guests:  |
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| I am unable to attend, but I would like to support DebRA's mission. |
Please keep me in mind for future events. Enclosed is my contribution for $ |
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Payment Information
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Check Enclosed for: | $ |
| | (Please make payable to DebRA of America) |
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Visa
Mastercard
American Express
Discover
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| Card No.: |  |
| Expiration Date/Zip Code: |
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| Name on Card: |
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| Signature: |  |