IHCA Foundation Convention Fundraiser: Massage Appointments

CONTACT INFORMATION

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* 1. First and Last Name

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* 2. Title

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* 3. Organization Name

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* 4. Phone

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* 5. Email

APPOINTMENT SELECTION

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* 6. How many sessions would you like to purchase? Cost is $20 per 10-minute session.

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* 7. Select your preferred time slot(s). Time slot availability will be confirmed at the time payment is received. You will receive a confirmation email with your confirmed time slot prior to the event. Massages will take place Monday, September 26.

11:00

11:10

11:20

11:30

11:40

11:50

12:00

12:10

12:20

12:30

12:40

12:50

1:00

1:10

1:20

1:40

1:50

2:00

2:10

2:20

2:30

2:40

2:50

3:00

4:00

RAFFLE ENTRY (OPTIONAL)

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* 8. I would also like to make an additional donation to participate in a raffle for the chance to win $250 for my organization to bring a massage therapist on site to provide staff massages. I understand that raffle tickets cost $25 each, and that a maximum of $500 must be raised by Monday, September 26 at 5 p.m. If $500 is raised, prizing drawing will take place Tuesday, September 27 during the Convention general session.

Yes

No

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* 9. How many raffle tickets would you like to purchase? Cost is $25 per ticket.