InterPACK Group Registration

School Name(Required)

Attendees Information

Name	Position	Cell Phone	Email	Do you have any dietary restrictions?	If Yes, please indicate	Registration Type	T-Shirt Size	Actions

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Total Registered

Product Name

Price: $0.00

Total

Payment(Required)

If check, please make the check payable to PA Circle K and mail it to: PA District Kiwanis International, 125 North Enola Drive, Suite 206, Enola, PA 17025. Registration will be cancelled and you will be billed for 50% of the cost, if your check is not received by November 7, 2022 at 5:00 PM.

Primary Contact Full Name(Required)

This person is responsible for payment for the group.

Primary Contact Email(Required)

This is the email that will receive payment receipt.

Credit Card

Card Details

Cardholder Name

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Kids Need Kiwanis

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