CAULIFLOWER ALLEY CLUB MEMBERSHIP *To pay via Check or Money Order mail form to: Cauliflower Alley Club 10823 Indian Hills Court, Unit 29 Seminole, FL 33777
NEW RENEW AMERICA ANNUAL: $25 via Check* $27.50 via Credit Card**
PAYMENT OPTIONS • Check • Money Order
**To pay via Credit Card mail this form to above address with Credit Card information ***To pay via PayPal go to www.caulifloweralleyclub.org/shop and follow instructions. Name _____________________________________________ Ring Name _________________________________________ Address ___________________________________________ City __________________ State _________ Zip __________ E-mail _____________________________________________ Phone _____________________________________________ Accomplishments in wrestling (or send resume) ___________ __________________________________________________ ___________________________________________________
AMERICA LIFETIME: $300 via Check* $307 via Credit Card** CANADA ANNUAL: (U.S. Funds) $35 via Check* $37.50 via Credit Card**
OVERSEAS ANNUAL: (U.S. Funds) $45 via Money Order* $47 via Credit Card**
CANADA LIFETIME: (U.S. Funds) $450 via Check* $460 via Credit Card**
OVERSEAS LIFETIME: (U.S. Funds) $550 via Money Order* $565 via Credit Card**
To charge membership via mail Credit Card # ______________________________________ Amt. Charge _________ Expiration Date ________________ Name of credit card holder ___________________________
To pay via PayPal please visit: www.caulifloweralleyclub.org
2021 CAC BANQUET/BOCKWINKEL BLOWOUT Gold Coast Hotel & Casino in Las Vegas, NV Blowout: APR 27, 2021 TICKET OPTIONS Banquet: APR 28, 2021 MEMBERS PAYING Total number of Tickets You Wish to Order __________
PRINT & MAIL FORM TO: CAULIFLOWER ALLEY CLUB 10823 INDIAN HILLS COURT UNIT 29 SEMINOLE, FL 33777
NO BANQUET TICKETS SOLD AT DOOR!
ALL ORDERS BY CHECK MUST BE IN U.S. FUNDS, INCLUDING CANADIAN and OVERSEAS ORDERS
(List the RING NAME of each person who will be using the tickets) PRINT NAME CLEARLY ____________________________________________
VIA CHECK:
____________________________________________
DOMESTIC: $125 per person for both nights
____________________________________________
CANADIAN: $125.00 (U.S. Funds) per person for both nights
Enclosed is a check in the amount of _____________
MEMBERS PAYING VIA CREDIT CARD:
in the amount of ______________ for _____ tickets.
DOMESTIC: $127.50 per person for domestic orders for both nights
If paying by credit card:
____________________________________________
or charge my credit card
Credit Card #__________________________________ Amt. Charge___________ Exp. Date____________
CANADIAN: $131.00 per person for Canadian residents for both nights
Name of credit card holder ______________________ E-mail __________________________________________ *To pay via Check or Money Order mail form to: Cauliflower Alley Club 10823 Indian Hills Court, Unit 29 Seminole, FL 33777 **To pay via Credit Card mail this form to above address with Credit Card information
OVERSEAS: $132.00 per person for overseas residents for both nights MEMBERS PAYING VIA PAYPAL: Please visit: www.caulifloweralleyclub.org
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