Space Coast Round-Up 2024 Registration Cost: $35.00 Note: A PayPal account is not required - only a valid credit/debit that will be processed through PayPal Please contact Brevard Intergroup @ 321-724-2247 with any questions. Number of Registrations 1 - $35.002 - $70.003 - $105.004 - $140.00 Add on a Lunch with the Speaker's Banquet Ticket! 0- $0.001 - $30.002 - $60.003 - $90.004 - $120.00 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 TypeAAAL-ANON Select to Display Second Registration Information (required) 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 TypeAAAL-ANON Select to Display Third Registration Information (required) 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 TypeAAAL-ANON Select to Display Fourth Registration Information (required) 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 TypeAAAL-ANON Note: A PayPal account is not required - only a valid credit/debit that will be processed through PayPal Δ
