Company Name: _______________________________________ Contact: ____________________________________
Number of attendees _______ at $35.00 each = _______________ Phone Number: ______________________________
Persons attending:_______________________________________ ____________________________________________
________________________________________ ____________________________________________
[ ] Sign me up for a Vendor Table at $150.00 plus an auction item of $100 retail value (includes 1 admission)
[ ] Sign me up to sponsor a Gaming Table at $250.00
* I will provide a dealer for the entire evening ___YES ___NO
* I will provide a dealer for 1/2 of the evening ___YES ___NO
[ ] I want a Vendor Table and Gaming Table at $400.00 plus an auction item of $100 retail value (includes 2 admissions &
website ad)
Payment must accompany reservation. Total amount enclosed ____________________
10 - Black Jack Tables
1 - Craps Table
1 - Roulette Table
4 - Texas Hold’em Tables
Credit card payment: Type of card: ___ MC ___ VISA
Card Number:_________________________________________ Exp:________ CVV Code:_______
Billing Address:______________________________________City:_________________________ ST._____ Zip________
Total Amount to be charged: $____________ Signature:—————————————————————