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CASINO NIGHT

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					THE CASINO CONNECTION
                 CASINO NIGHT REGISTRATION FORM
NAME: _________________________________________ PHONE: ________________________
E-MAIL: _______________________________                    TODAY’S DATE: _______________________
ADDRESS: _____________________________________________________________________
1. Type of Event: check one of the following if applicable:
       Birthday Party (guest of honor: _______________________________________________)
       Anniversary (guests of honor: ________________________________________________)
       Bachelor Party (groom: _____________________________________________________)
       Bachlaurete Party (bride: ___________________________________________________)
       Athletic Team Fund Raiser (name of team/organization: _____________________________)
       Non Profit Organization Fund Raiser (name of organization: __________________________)
       Company Party (name of company: _____________________________________________)
       Retirement Party (guest of honor: _____________________________________________)
       Other: __________________________________________________________________
2. Desired Date:     _______________ _______________ _______________
                          1st choice              2nd choice        3rd choice
3. Number Of People: __________
4. Time Of Event: From ______ To _____
5. Desired Location:
        Personal Residence:
               Address: ____________________________________________________
               Owners: ____________________________________________________
        Hall:
               Address: ____________________________________________________
               Name of Facility: _____________________________________________
6. Form of Gaming: check one of the following:
        Participants to use their own cash
        Participants to bring a gift to auction and receive casino chips at the door
        Host to provide gifts to be auctioned & participants get casino chips at the door
        Merchants to provide gifts to be auctioned & guests get casino chips at the door
7. Type and number of tables requested:
        Blackjack: _____            Poker: _____                         Other: __________________
        Craps: _____                Texas Hold ‘Em: _____
        Roulette: _____             Bacarat: _____
8. Gaming Lessons Requested (check one): Yes No
9. Advertising Requested (check one):      Yes No Approximate Budget: $______
10. Band or DJ Requested (check one):      Yes No Approximate Budget: $______
11. Catering Requested (check one):        Yes No Approximate Budget: $______
12. Decorating Requested (check one):      Yes No Approximate Budget: $______
13. Other Entertainment Requested:         Yes No Approximate Budget: $______
14. Approximate Total Budget: $______________

				
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