Zabawa Walentynkowa | Valentine's party | The Polish Club of Denver

How many people are you registering? *

(including yourself)

Pana/Pani Rejestracja | Your Registration Info

Imię | First Name *

Nazwisko | Last Name *

An email address is required to send a receipt. Please do not use the same email address for multiple participants.

Adres Email | Email Address

Event Fee(s) *

wejście i obiad | admission and dinner - $ 45.00

wejście | admission - $ 25.00

Total for this participant

Credit Card

Card Type

Card Number *

Security Code *

Expiration Date *

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *

Preferencje | Preferences

W miarę możliwości, osoby które podały taką samą nazwą będą przypisanie do tego samego stolika. | If possible, persons who provided same table name will share a table.

Nazwa stolika | Table name

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Zabawa Walentynkowa | Valentine's party