Individual Registration

Please enter information in the form below to process registration for event Ticket Types - Collect Members.

Ticket Information

Ticket Type	Price	Available Place
Children Tickets for children. Maximum 3 tickets per booking	$50.00	28
Student Tickets for Students. Maximum 2 tickets per booking	$80.00	24
Standard Standard Tickets. Maximum 4 tickets per booking	$100.00	50
VIP Tickets VIP Tickets. Maximum 2 tickets per booking	$200.00	9

Billing Information

First Name *

Last Name *

Organization

Address

Address 2

City

Zip

Country *

State *

Phone

Email *

Payment Information

Coupon

Amount

$

Discount Amount

$

Tax Amount

$

Payment Processing Fee

$

Gross Amount

$

Payment Method *

Paypal Authorize.net Eway Worldpay Offline Payment

Credit Card Number*

Expiration Date*

/

Card (CVV) Code*

Card Holder Name*

Contact

Walking Street, Los Angeles, California, USA

info@eventchamp.com

+90 312 69 12

+55 215 70 20

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