Derby Day Luncheon Registration - Herb Society of America, Baton Rouge Unit

Derby Day Luncheon Registration

Please enter name, phone number, and e-mail address of each person attending. If registering more than three, please use additional forms.

* Indicates required field

Name *

First

Last

Phone Number *

Email *

Member of HSABR? *

Yes $35 No $40

Name: *

First

Last

Phone Number *

Email *

Member of HSABR *

Yes $35 No $40

Name: *

First

Last

Phone Number *

Email *

Member of HSABR? *

Yes $35 No $40

Comments or questions: *

Payment in full is due at time of registration. The cost of the luncheon is $40 per person, $35 each for members of HSABR. On the confirmation page that will appear after you submit this form, please click the PayPal link and pay the appropriate amount.

If you prefer to pay by check, please make checks payable to "HSABR" and mail to the Treasurer, Cathy Scarbrough, 9355 Woodbine St., Baton Rouge, LA 70815; 225-928-3676.

Your registration is not complete until we receive payment.

Submit