Host Team Registration Souly Business - November 1 to 3, 2019 - Host Team Attendee Step 1 of 3 - Attendee Information 0% Attendee InformationName* First Last Phone*Email* Age*Home City and State* City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific Do You Require a Plugin for a Sleep Apnea Machine?*NoYesWho Invited You? First Last Which roles have you served at Souly Business?Please note, this is not asking you where you would like to serve. Speaker Table Listener Assistant Table Listener Table Servant Kitchen Music/Sound/Photography Speaker Escort Coffee/Welcome/Toilets Prayer Leader Roamer Table Servant Room Facilities/Logistics/Ground This is my first time to serve on host team Emergency Contact InformationSpouse or Significant Other Name First Last Spouse or Significant Other Phone NumberSpouse or Significant Other Email Payment InformationPayment Type*Credit/debit cardCheckI'd like to request a scholarshipCredit Card Fee I would like to add the credit card fee to my total, so Influencers Bakersfield receives the entire registration fee. Total Amount To Be Charged $0.00 Credit Card* American ExpressDiscoverMasterCardVisa Card Number Expiration Date Month010203040506070809101112 Year20192020202120222023202420252026202720282029203020312032203320342035203620372038 Security Code Cardholder Name Pay by Check Please write name of attendee and event date in memo field, and send your check to Bakersfield Influencers PO Box 22811 Bakersfield, CA, 93390Cancellation Policy*Full payment is required at the time of your reservation. You may cancel your registration and receive a full refund of your registration fee up to 4 weeks prior to the date of the event. If you cancel your registration between 2 and 4 weeks prior to the date of the event, you'll receive a refund of $150 ($225 registration fee minus a $75.00 handling fee). In the event that you cancel your registration less than 2 weeks prior to the date of the event, you will forfeit the entire registration fee. Regardless of when you cancel your registration, your registration is not transferable to another event or date; however, you can transfer your paid registration to another person. If you need to cancel your ticket, or have any questions please feel free to contact email@example.com. I have read and agree to the cancellation policy. This iframe contains the logic required to handle Ajax powered Gravity Forms.