Epique Tri-State Birthday Registration

Agent Full Name

First NameLast Name

Epique Email Address

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Agent T-shirt Size (Agents only)

Will you be bringing a guest

Guest Full Name

First NameLast Name

Any Additional Guests

Please List Additional Guest Names

After registering for the event you will receive a Thank You message confirming your registration. You will also be able to select a room block at Margaritaville if you would like to stay overnight.

My Products

Guest Registration

Guest admission to the party, includes dinner. Please Select how many GUESTS total you are bringing, do not include yourself (agents are free) in this total. If the number selected here does not match the above information we may reach out to you to request additional payment.

$40.00 Quantity
Item subtotal:

Check the box to add a Guest T-shirt

Optional T-shirt for guests. If you are not purchasing a guest tshirt please leave the box unchecked. If you are purchasing a guest tshirt, check the box and choose the size and quantity needed

$10.00

Size	Quantity	Price
XS		$10.00
S		$10.00
M		$10.00
L		$10.00
XL		$10.00
XXL		$10.00
XXXL		$10.00

Item subtotal:

Total

Debit or Credit Card
Credit Card Number	Security Code
Expiration Month	Expiration Year