Get A Life Marching Band
Mardi Gras 2011 Deposit
Fields marked *
are required
Contact Information
*
Last Name :
Please submit one signup
for each person. IMPORTANT: Use the name that
is shown on the identification you will use at the airport!
*
First Name :
Please submit one signup
for each person. IMPORTANT: Use the name that
is shown on the identification you will use at the airport!
*
EMail:
Current email address
*
Phone Number:
Include area code (EX:
503 555 1212)
*
Instrument or Section:
Flute / Piccolo
Clarinet
Bass Clarinet
Alto Sax
Tenor Sax
Baritone Sax
Trumpet / Cornet
F Horn
Trombone
Baritone Horn / Euphonium
Tuba / Sousaphone
Drums
Aux Percussion / Trash Line
Bells
Twirler
Dance Team
Color Guard (Tom's folks)
Banner & Flags (US, Oregon, etc)
Family Member (roadie)
Family Member (non-band)
Please select your instrument or
unit
Hotel & Air Information
*
Package Type:
Full package includes
Air transportation, Hotel, Ground transportation in and around New Orleans.
FULL PACKAGE IS AVAILABLE ONLY TO PDX TRAVELERS -- all other
travelers should choose Hotel + Ground.
Hotel + Ground excludes Air transportation -- YOU MUST MAKE YOUR OWN
TRAVEL ARRANGEMENTS TO NEW ORLEANS IF YOU SELECT THIS OPTION.
*
Room Type:
Single (1 per room)
Double (2 per room)
Triple (3 per room)
Quad (4 per room)
Please select
PRICING VARIES by number
of people in room; see Event Information page for details.
Names of preferred roommates:
Payment Information
*
Credit Card Type:
American Express
Discover
Mastercard
Visa
Will Call Tom
Please select payment type
American Express, Discover,
Mastercard, Visa. Alternatively, you can select "Will Call Tom"
and then contact Tom with your payment information. PLEASE NOTE that
you should still enter your correct credit card name and address info
below even if selecting "Will Contact Tom". Click
here for Tom's contact information .
*
Credit Card Number:
Please format in four digit groups for ease of reading
(EX: 1223 4325 8828 5555).
If selecting "Will Call Tom", please enter zeroes.
*
Expiration Date:
Please use MM/YYYY format
(EX: 03/2012).
If selecting "Will Call Tom", please enter 0/0000
*
CC Validation Code:
Three-digit code on the back of credit card
(For American Express: four-digit code on front of card)
Click
here for help locating your CCV code.
If selecting "Will Call Tom", please enter 000.
*
Name on Credit Card:
Exactly as shown on
card (i.e., include middle initial if shown)
*
Address Line 1:
Billing address for
credit card
Address Line 2:
Billing address for
credit card
*
City:
Billing address for
credit card
*
State:
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VT
WA
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WV
WY
Please Select
Billing address for
credit card
*
Zip Code:
Billing address for
credit card
Comments: Anything else you want to tell us or ask us. (Be aware
that we may not know the answers to all your questions yet!)