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First Name
*
Last Name
*
Email Address
*
Number of Attendees
*
1
2
3
4
5
6
7
Ticket Options *Entries are put into a number lottery for 1 winner to win a special MDS swag bag! (more entries, more chances to win)
*
MDS Family Ticket *(includes 1 entry for giveaway) ($18.00)
MDS Family Ticket *(includes 2 entries for giveaway) ($36.00)
MDS Family Ticket *(includes 3 entries for giveaway)($54.00)
Name on Card
*
Credit Card Type
*
Visa
MasterCard
American Express
Discover
Credit Card Number
*
Expiration Date (mm/yy)
*
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