Registration: $35.00 Add on a Meet the Speakers Lunch Buffet ticket for $30.00! -Buffet with spring mix salad, pepper crusted tri-tip with cremini mushrooms & shallots, grilled mahi with caper leek sauce, white cheddar Yukon mashed potatoes & seasonal vegetable. Chef dessert selection! Note: A Paypal account is not required, but a valid credit/debit card is. Registration is not complete until a payment confirmation email and an email confirming registration information is received. Please contact Brevard Intergroup @ 321-724-2247 with any questions. Add on a Lunch Buffet for $30.00 per ticket! 0 - $00.001 - $30.002 - $60.003 - $90.004 - $120.00 Number of Registrations 1 - $35.002 - $70.003 - $105.004 - $140.00 Full Name (required) Badge Name (required) Address (required) City (required) State (required) Zip (required) Phone (required) Email (required) Sobriety Date Home Group Accessibility Requirements Needed? Are you willing to volunteer? YESNO Registration Type AAAL-ANON Select to Display Second Registration Information (required) Second Registration Full Name (required) Badge Name (required) Address City State Zip Phone Email (required) Sobriety Date Home Group Accessibility Requirements Needed? Are you willing to volunteer? YESNO Registration Type AAAL-ANON Select to Display Third Registration Information (required) Third Registration Full Name (required) Badge Name (required) Address City State Zip Phone Email (required) Sobriety Date Home Group Accessibility Requirements Needed? Are you willing to volunteer? YESNO Registration Type AAAL-ANON Select to Display Fourth Registration Information (required) Fourth Registration Full Name (required) Badge Name (required) Address City State Zip Phone Email (required) Sobriety Date Home Group Accessibility Requirements Needed? Are you willing to volunteer? YESNO Registration Type AAAL-ANON Δ
