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Custom Event Payment
Using this form, you may register only one LIREG member for the event, but you may register as many guests as you like.
1
Attendees
2
Payment
Attendees
First Name
Last Name
Gender
Organization
Email
Actions
Edit
Delete
There are no
Attendees.
Add Attendee
Maximum number of attendees reached.
Member attendee is free. Additional attendees / guests are $40 each.
Email
*
Amount
*
Custom Event
*
Price:
$0.00
Ticket Type
*
Golf
Tennis
Dinner Only
Women's Golf Clinic
Men's Golf Clinic
Tennis/Golf Clinic
Payment Type
*
Credit Card
Offline Payment
Payment Notes
Discount
$0.00
$75 off for members who buy Golf
Coupon
Total
$0.00
Total Amount
Credit Card
*
American Express
Discover
MasterCard
Visa
JCB
Maestro
Card Number
Month
01
02
03
04
05
06
07
08
09
10
11
12
Year
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
Expiration Date
Security Code
Cardholder Name
Member attendee is free. Additional attendees / guests are $40 each.
First Name
*
Last Name
*
Gender
*
Select
Male
Female
Organization
*
Email
*