4th of July Raffle Form Sign up to win a reserved parking spot or table on 4th of July! Name(Required) First Last Email(Required) Phone(Required)1 Raffle Ticket - 10:00-2:00 Parking Spot QuantityOne entry into the raffle - raffle winner will receive a parking spot on 4th of July, from 10:00-2:00! Price: $20.00 Quantity 5 Raffle Tickets - 10:00-2:00 Reserved Parking Spot QuantityFive entries into the raffle - raffle winner will receive a parking spot on 4th of July, from 10:00-2:00! Price: $75.00 Quantity 1 Raffle Ticket - Reserved Table from 10:00-2:00 QuantityOne entry in the raffle - winner will receive a round table and four chairs, reserved from 10:00-2:00 on 4th of July! Price: $20.00 Quantity 5 Raffle Tickets - Reserved Table from 10:00-2:00 QuantityWinner will receive 5 entries into the raffle - for a round table and four chairs, reserved from 10:00-2:00 on 4th of July! Price: $75.00 Quantity 1 Raffle Ticket - Reserved Parking Spot from 2:00-6:00 QuantityOne entry into the raffle - raffle winner will receive a parking spot on 4th of July, from 2:00-6:00! Price: $20.00 Quantity 5 Raffle Tickets - Reserved Parking Spot from 2:00-6:00 QuantityFive entries into the raffle - raffle winner will receive a parking spot on 4th of July, from 2:00-6:00! Price: $75.00 Quantity 1 Raffle Ticket - Reserved Table from 2:00-6:00 QuantityOne entry in the raffle - winner will receive a round table and four chairs, reserved from 2:00-6:00 on 4th of July! Price: $20.00 Quantity 5 Raffle Tickets - Reserved Table from 2:00-6:00 Quantity5 entries into the raffle - winner will recieve a reserved round table and 4 chairs, from 2:00-6:00 on 4th of July! Price: $75.00 Quantity Total Payment Method(Required) Credit Card ACH Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20262027202820292030203120322033203420352036203720382039204020412042204320442045 Security Code Cardholder Name ACH Account Number Account Type SelectSavingsChecking Routing Number Account Holder Name Order Token
