When

Saturday, September 23, 2017 from 6:30 PM to 11:30 PM EDT
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Where

Matt's Casbah, Downtown Melbourne

801 East New Haven Avenue
Melbourne, FL 32901

Contact

Kim Deffebach, Event Chairperson
Club Esteem
321-223-0147
kimdeffebach@gmail.com

Rock the Casbah 2017 Registration

* Required information

Personal Information

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  • Fee

    Type Fee
    $150.00
    $500.00
    $1,000.00
    $2,500.00
    $5,000.00
    $7,500.00
    $10,000.00
    $15,000.00

Additional Guests Information

You may add a maximum of 10

Business Information

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    Company Matching Program?

$9,999.99

Payment

Payment Method

  • Please make check payable to:
    Club Esteem
    3316 Monroe Street
    Melbourne, FL 32901

Payment Summary


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