Merge Weekend for Engaged Couples $

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Merge Weekend for Seriously Dating and Engaged Couples

Registration Information

Merge Weekend 8/25-8/26 All Registrations

NOTE: Please enter unique information for each individual you are registering.

Who do you wish to register?*

Her Him Both

Her Information

Her Name*

First Name

Last Name

Her Phone*

Her Email*

Her Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Her Date of Birth*

Her name as it will appear on the certificate:*

(Name as it will appear on marriage license (must match proof of identity)

His Information

His Name*

First Name

Last Name

His Phone*

His Email*

His Address*

Address Line 1

Address Line 2

City

State

ZIP Code

His Date of Birth*

His name as it will appear on the certificate:*

(Name as it will appear on marriage license (must match proof of identity)

Payment

Total $

Name on Credit Card*

First Name

Initial (optional)

Last Name

Credit Card*

Merge Weekend for Seriously Dating and Engaged Couples

Registration Information

Her Information

His Information

Additional Information

Payment