EmailMe Form - Casino Fundraiser

Number attending

Your information as group contact person

Your Name *

First Last

Your Date of Birth *

MM / DD / YYYY

Must be 21 or older with valid ID

Your Address *

Street Address City State / Province / Region Postal / Zip Code

Your Email Address *

Confirm

Your Phone Number *

### - ### - ####

Your Greektown Players Club Number (if applicable)

Info for Person #2 (required tour company)

Person #2 Name *

First Last

Person #2 Date of Birth *

MM / DD / YYYY

Must be 21 or older with valid ID

Person #2 Address *

Street Address City State / Province / Region Postal / Zip Code

Person #2 Email Address

Person #2 Phone Number *

### - ### - ####

Person #2 Greektown Players Card Number (if applicable)

Info for Person #3 (required by tour company)

Person #3 Name *

First Last

Person #3 Date of Birth *

MM / DD / YYYY

Must be 21 or older with valid ID

Person #3 Address *

Street Address City State / Province / Region Postal / Zip Code

Person #3 Email Address

Person #3 Phone Number *

### - ### - ####

Person #3 Greektown Players Card Number (if applicable)

Info for Person #4 (required by tour company)

Person #4 Name *

First Last

Person #4 Date of Birth *

MM / DD / YYYY

Must be 21 or older with valid ID

Person #4 Address *

Street Address City State / Province / Region Postal / Zip Code

Person #4 Email Address

Person #4 Phone Number *

### - ### - ####

Person #4 Greektown Players Card Number (if applicable)

Info for Person #5 (required by tour company)

Person #5 Name *

First Last

Person #5 Date of Birth *

MM / DD / YYYY

Must be 21 or older with valid ID

Person #5 Address *

Street Address City State / Province / Region Postal / Zip Code

Person #5 Email Address

Person #5 Phone Number *

### - ### - ####

Person #5 Greektown Players Card Number (if applicable)

Info for Person #6 (required by tour company)

Person #6 Name

First Last

Person #6 Date of Birth *

MM / DD / YYYY

Must be 21 or older with valid ID

Person #6 Address *

Street Address City State / Province / Region Postal / Zip Code

Person #6 Email Address

Person #6 Phone Number *

### - ### - ####

Person #6 Greektown Players Card Number (if applicable)

Question or Note

Hitting 'Submit' will send us your registration and take you to a payment form. You can pay there, or cancel out of that page and mail your payment to Shelter to Home, 266 Oak Street, Wyandotte, MI 48192.