Ptown Roundup

Registration Name & Contact

First Name

Last Name

Phone Number

Email Address

Re-enter Email Address

Primary Program

Sobriety Date

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Country

United States

Home State

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Refund/Cancellation Policy

Registered guests may cancel and request a full refund until September 30, 2024. The refund request must be received by Midnight (EDT) on September 30th, 2024. If you cannot attend, we’d encourage donations to the scholarship fund. After that date, the registration may be transferred to another guest, or converted to a scholarship donation to the Roundup.

I have read and accept the Refund/Cancellation policy outlined above.

Registration - 2024

General Registration

I would like to make use of ASL or CART Services at the Roundup.
I would like to appear in the Cabaret at the Roundup.

$125.00

Scholarship Donation:

Coffee Donation:

Grand Total:

Payments are processed on the Square App website.