EmailMe Form - Piedmont Friends Fall Gathering 2023

Registration Name: Adult 1 *

First Last

Email *

Confirm Email

MEETING AFFILIATION

I am a young adult student

YES

Name: Adult 2

First Last

Email

MEETING AFFILIATION

I am a young adult student

YES

I will be bringing a Young Friend to the Fall Gathering

YES.

Please include names and ages here

Name: Child 1

First Last

AGE:

Name: Child 2

First Last

AGE:

Name: Child 3

First Last

AGE:

Yes, I will make an ONLINE payment to PIEDMONT FRIENDS for my registration.

YES, I will use Piedmont Friends STRIPE site .

NO, I will send a check to:

Piedmont Friends
4701 Juniper Rd.
Efland, NC 27243

You will be transferred to the Piedmont Friends STRIPE page when you SUBMIT this form. (If sending a check, simply close the STRIPE page.)

Number of Tickets I'm purchasing ($20 each)

Total Ticket Cost

$ Dollars . Cents

I would like to add a Donation to PIEDMONT FRIENDS to support the Fall Gathering expenses.

$ Dollars

You may make ONE online combined payment for the tickets and donation.

Questions or Comments

Once you SUBMIT this registration, you will receive a confirmation email; you may need to check your spam.