Wufoo
Autism Eats - April 24, 17 -Pasta House Festus MO
1606 Galemore St
Festus, MO
6:00pm to 8:00pm
April 24, 2017
Adult Admission: $16.00
Kids: $10.00
Delicious buffet includes full dinner, dessert, soft drinks, tax and tip. Please let us know if you have any dietary restrictions.
Please let us know in advance if you have any questions or if a Gluten Free meal is required
Name
*
First
Last
Email
*
Phone Number
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How Many Adults will be attending?
One Adult - $16
Two Adults - $32
Three Adults - $48
Four Adults - $64
Five Adults - $80
None- Just want to leave a donation below
How Many Children will be attending?
One Child - $10
Two Children - $20
Three Children - $30
Four Children - $40
Five Children - $50
None- Just want to leave a donation below
Is a Gluten Free Meal Required?
No
Yes
How many Gluten Free Meals are needed?
Enter a number between
0
and
10
.
Where did you learn about Autism Eats?
What city and state do you live in?
Contribution:
Please consider making a contribution so all those who want to attend are able to. $10.00, $25.00 $50.00 $100.00
Contribution Amount:
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