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Registration Form
Poplar Bluff Arts & Events Center
(Complete, Print & Mail)
| NAME: |
| ADDRESS: |
| CITY/STATE/ZIP: |
| TELEPHONE NUMBERS: |
| EMAIL: |
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EVENT TITLE: |
| EVENT DATE:
COST OF EVENT: $ |
| HOW DID YOU HEAR ABOUT US? |
Card holder acknowledges receipt of goods and/or services in the amount of the total shown hereon and agrees to perform the obligations
set forth in the cardholder's agreement with the issuer.
| Cash Amount: $ |
Check
# Amount: $ |
Date: |
If, for any reason, an event is canceled by
Poplar Bluff Arts & Events Center, a full
refund will be issued. If a customer cancels one month or more before the scheduled
event, a refund will be issued minus a 25% fee. If a customer cancels
less than one month in advance, no refund is issued but you may reschedule one
time with the restaurant's permission.
PLEASE MAKE CHECKS PAYABLE TO:
Mail to:
PBAEC
301 S. Main Street, Suite B
Poplar Bluff, MO 63901-5833
Telephone: 573-778-3289
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