Annual Dinner Reservation Form
Thursday, April 30, 2026 - 6:00 pm at The Factory, Ballston Spa, NY
Primary Name (payment person)
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
Please Select
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State
Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
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Guest 2
First Name
Last Name
Guest 3
First Name
Last Name
Guest 4
First Name
Last Name
Guest 5
First Name
Last Name
Guest 6
First Name
Last Name
My Products
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Luminary Ticket
Number of guests for Annual Dinner
$
50.00
Quantity
1
2
3
4
5
6
Item subtotal:
$
0.00
Torch Bearer Tickets
Number of guests for Annual Dinner
$
75.00
Quantity
1
2
3
4
5
6
Item subtotal:
$
0.00
Love and LIght Ticket
Number of guests for Annual Dinner
$
100.00
Quantity
1
2
3
4
5
6
Item subtotal:
$
0.00
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Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
Submit
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