Who is completing this registrationI'm not attending, but I'm registering one or more attendees at the same organization
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 ConsentI DO NOT authorize name(s) and registered company/organization to be listed on the event attendee list.
Company Info
Non-attendee POC
Name Phone Email Address
Kim Barnes 850-833-9509 kbarnes@fwb.org
What email address should we send the receipt to?Email hidden; Javascript is required.
Company, Organization, School, Municipality, or Military BranchCity of Fort Walton Beach
Company Phone8508339509
Credit Card Billing Address107 Miracle Strip Pkwy SW
Fort Walton Beach, Florida 32548
Map It
Attendee Registration Info
How many attendees are you registering?4
Attendee 1
Name Rank, Agency Title, or Elected Title Email Address
Gloria DeBerry Council Member gdeberry@fwb.org
Attendee 2
Name Rank, Agency Title, or Elected Title Email Address
Debi Riley Council Member driley@fwb.org
Attendee 3
Name Rank, Agency Title, or Elected Title Email Address
Ben Merrell Council Member bmerrell@fwb.org
Attendee 4
Name Rank, Agency Title, or Elected Title Email Address
Logan Browning Council Member lbrowning@fwb.org
Total Purchase$100.00
Complete and Pay
Credit Cardvisa
XXXXXXXXXXXX4991