Partners for Life Tickets

Fields marked * require an entry.

Package Name	Amount	Subtotal

BRONZE Partners for Life Ticket Package (2 included)	$500.00	$0.00



SILVER Partners for Life Ticket Package (4 included)	$1,000.00	$0.00



STERLING Partners for Life Ticket Package (2 included)	$0.00	$0.00



GOLD Partners for Life Ticket Package (4 included)	$0.00	$0.00



PLATINUM Partners for Life Ticket Package (10 included)	$0.00	$0.00

Online Convenience Fee:

4.00%

Total:

$0.00

As a convenience, you may pre-register a credit card on the submission page to charge your purchases at event.

I authorize DAP Health, Inc. to use the credit card entered on the submission page at event. Once the transaction has completed successfully, a confirmation receipt will be sent to the email address entered.

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