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Register
* Mandatory Field
Date of Event:
November 1
st
2008
* Contact Name:
* Company:
* Address 1:
Address 2:
* City:
* Province:
* Postal Code:
* Phone:
* E-mail:
Fax:
* Credit Card:
VISA
Mastercard
* Credit Card Number:
* Expiry Date:
Amount per person:
$60.00 per person includes dinner, and first buy in for poker event.
* Total # of Attendees:
