2022 MIC Guest Only Registration

First Name *

Last Name *

Nickname for Badge *

What are your preferred pronouns? *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

Do you have any food allergies or preferences? *

Be sure to leave Guest Admission Checked. You may also choose to pre-purchase rainbow raffle tickets by checking either of the two options below. *

Guest Admission ($50.00)

Rainbow Raffle Pack ($50.00)

Rainbow Raffle Pack ($100.00)