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Online Registration for Young Electrical Professionals

Summer Event: Revolution Brewing Company Social Event & Cornole Tournament, Raising money for Chicago's Homeless Children

View the Event Information here

Thursday, July 19th - 5:30pm to 8:30pm

Full Name
Company
Company Street Address
Company City, State, ZIP
Phone
Fax
Email Address
   
Participating in
Cornhole/Bags Tournament?
           
Team Member #1 Name:
Company:

Team Member #2 Name
Company:

 

$50 per person for event entrance, $25 additional for "Bags" tournament entry. Cash prizes awarded to top finishers in Cornhole tournament.

Total Amount:
 

You can print this form and mail it with a check to the Electric Association:17W733 Butterfield Road,Suite B, Oakbrook Terrace, IL 60181 (or) Visa, MasterCard, and American Express are accepted below.

Refunds will not be given for this event with less than a 48 hour cancellation.

Method of Payment (a 5% convenience charge will be added to all credit card payments)
Credit Card Number
CC Exp. Date
Cardholder name
  Credit card billing address is the same as company address above

If credit card billing address is different from company address, please specify below:
CC Billing Street Address
CC Billing City, State, ZIP