Curly Tails & Cocktails 2025 "*" indicates required fields ***NO INFORMATION ON THIS FORM WILL BE SHARED WITH ANY OUTSIDE ORGANIZATION, BUSINESS OR INDIVIDUAL*** Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* We will send your purchase confirmation to this email addressTicketsYou will not need to bring any printed tickets/documentation to the event. Check in is at the front desk under the name used to purchase the tickets. If you do not receive a ticket purchase confirmation email, please email us at info@pugpartners.com. Thank you for your support of Pug Partners of Nebraska!Pre-Registration Single Ticket Quantity Price: $45.00 Quantity Includes dinner and 2 drink tickets. Attendees must be 21 to attend this event.Pre-Register Two Tickets Quantity Price: $80.00 Quantity Includes 2 dinners and 4 drink tickets. Attendees must be 21 to attend this event.Pre-Register for a Table of 8 Quantity Price: $300.00 Quantity Includes 8 dinners and 16 drink tickets at a reserved table. All attendees must be 21 to attend this event.Total I understand that this event is benefitting a non-profit 501(c) (3) organization, Pug Partners of Nebraska, developed and coordinated by members and friends. By signing this form, I hereby waive any claims against the organizers or volunteers for any acts of negligence or breach of any actual or implied contract committed in connection with this event. I understand that I am entering this event at my own risk and I take full responsibility for my actions.* I have read and agree to the above. This form must be filled out - (either here online or in-person at registration) in order to participate attend Curly Tails & Cocktails 2025.Electronic Signature First Last Today's Date MM slash DD slash YYYY After clicking "Purchase Tickets" you will be sent to PayPal's website to enter your payment information and complete the transaction. Δ
