| Who is completing this registration | I'm not attending, but I'm registering one or more attendees at the same organization | ||||||
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| What type of Attendees are you registering? | Active Duty Military, Federal Civil Service, or State, Okaloosa County, or Okaloosa Municipality Elected Official ($25.00) | ||||||
| Event Attendee Publication Consent | I DO NOT authorize name(s) and registered company/organization to be listed on the event attendee list. | ||||||
| Company Info | |||||||
| Non-attendee POC |
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| What email address should we send the receipt to? | Email hidden; Javascript is required. | ||||||
| Company, Organization, School, Municipality, or Military Branch | City of Fort Walton Beach | ||||||
| Company Phone | 8508339509 | ||||||
| Credit Card Billing Address | 107 Miracle Strip Pkwy SW Fort Walton Beach, Florida 32548 Map It | ||||||
| Attendee Registration Info | |||||||
| How many attendees are you registering? | 4 | ||||||
| Attendee 1 |
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| Attendee 2 |
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| Attendee 3 |
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| Attendee 4 |
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| Total Purchase | $100.00 | ||||||
| Complete and Pay | |||||||
| Credit Card | visa XXXXXXXXXXXX4991 |
