Berkeley Lake HOA 4th of July Event Registration

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1. To receive advanced payment registration pricing, submit payment for all registrants listed. 
   Please enter the names of all persons (age 12 and older) in your group.

    Format: First name, Last name.
             ONE person per line
             Check SPELLING - What you type will appear on your pre-printed Name Tag(s)

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2. Please enter the names of all children (under age 12) in your group.

    Format: First name, Last name.
             ONE name per line
             Check SPELLING - What you type will appear on your pre-printed Name Tag(s)

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3. To keep costs down, we are requesting that each family bring a side dish.
    (Your dish should feed at least the number of people in your party plus one.)
    Please choose one of the side items below:

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4. If you would like to bring a dessert in addition to the side dish, your dessert should feed 6-8 people.
   If you choose to do so, please indicate what you will bring.

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5. Email address
   (so you can receive payment confirmation)

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6. Cell phone number
   (if the event manager has a question)

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7. Total number of people registered (12 and over).

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8. To receive the discounted rate of $15.00 per registrant (children under 12 are free), payment in full must be received before midnight on Friday, July 1st.  (Payments received on Saturday or later will be returned.)  Place your check in an envelope (please include your name and email address) in the stack stone column mailbox at 595 Lakeshore Drive.

You will receive a confirmation email for payment received.
If you do not receive a confirmation email within 24 hours of payment delivery, please notify the event manager at Events@BLHA.org. Provide your name and contact phone number.

Ticket Calculator                                                                                          
 # persons  (12 & older)   1      2      3       4       5       6       7        8       9       10
 Check Amount           $15    $30   $45    $60    $75     $90   $105   $120    $135   $150 

Please enter the amount due here.

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