1 Attendee Information Please do not use all caps when filling out this form. Are you a Sauder Village member? Yes No First Name Last Name Phone Number Email Address Street Address Suite/P.O. Box City State or Province Zip Code Country Country Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua & Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Azores Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire Bosnia and Herzegovina Botswana Brazil British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Canary Islands Cape Verde Islands Cayman Islands Central African Republic Chad Channel Islands Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia Cuba Curacao Cyprus Czech Republic Democratic Republic of Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador England Equitorial Guinea Eritrea Estonia Ethiopia Faeroe Islands Falkland Islands Federated States of Micronesia Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kiribati Kosovo Kosrae Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Madeira Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Poland Ponape Portugal Puerto Rico Qatar Republic of Yemen Reunion Romania Rota Russia Rwanda Saba Saipan San Marino Sao Tome and Principe Saudi Arabia Scotland Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Korea Spain Sri Lanka St. Barthelemy St. Christopher St. Croix St. Eustatius St. John St. Kitts & Nevis St. Lucia St. Maarten St. Martin St. Thomas St. Vincent & the Grenadines Sudan Suriname Swaziland Sweden Switzerland Syria Tahiti Taiwan Tajikistan Tanzania Thailand Tinian Togo Tokelau Tonga Tortola Trinidad & Tobago Truk Tunisia Turkey Turkmenistan Turks & Caicos Islands Tuvalu Uganda Ukraine Union Island United Arab Emirates United Kingdom United States Uruguay US Virgin Islands Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Gorda Wake Island Wales Wallis & Futuna Islands Western Samoa Zambia Zimbabwe
2 Select Food and Beverages Select the food and beverages you would like to register for below: Tuesday, August 13 Tuesday - 8/13/2024 - Chef Salad & Vegetarian Vegetable Soup & Angel Berry Trifle Dessert Price: $ Tuesday - 8/13/2024 - Vegetarian Option - Salmon Price: $ Tuesday - 8/13/2024 - Vegan Option - Avocado Salad Price: $ Wednesday, August 14 Wednesday - 8/14/2024 - Greek Grilled Chicken Wrap with Pasta Salad & Lemon Bars Price: $ Wednesday - 8/14/2024 - Vegetarian Option - Salmon Price: $ Wednesday - 8/14/2024 - Vegan Option - Jackfruit Price: $ Thursday, August 15 Thursday - 8/15/2024 - Half Sandwiches - Focaccia Turkey Sandwich & Chicken Salad Croissant and Broccoli Salad & Brownie Price: $ Thursday - 8/15/2024 - Vegetarian Option - Egg Salad Price: $ Thursday - 8/15/2024 - Vegan Option - Avocado Salad Price: $ Friday, August 16 Friday - 8/16/2024 - Asian Chicken Salad with honey lime slaw wontons & fresh fruit salad Price: $ Friday - 8/16/2024 - Vegetarian Option - Salmon Price: $ Friday - 8/16/2024 - Vegan Option - Jackfruit Price: $ Saturday, August 17 Saturday - 8/17/2024 - Chicken Caesar Salad Buffet with Broccoli Cheddar soup & Chocolate Trifle Dessert Price: $ Saturday - 8/17/2024 - Vegetarian Option - Salmon Price: $ Saturday - 8/17/2024 - Vegan Option - Portobello Mushroom Price: $
Thursday - 8/15/2024 - Half Sandwiches - Focaccia Turkey Sandwich & Chicken Salad Croissant and Broccoli Salad & Brownie Price: $
Saturday - 8/17/2024 - Chicken Caesar Salad Buffet with Broccoli Cheddar soup & Chocolate Trifle Dessert Price: $
3 Payment Credit Card # Name on Card Expiration Month 1 2 3 4 5 6 7 8 9 10 11 12 Expiration Year 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 Security Code Same Address as Attendee? Yes No Billing First Name Billing Last Name Billing Phone Number Billing Email Address Billing Street Address Suite/P.O. Box City State or Province Zip Code Country Country Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua & Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Azores Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire Bosnia and Herzegovina Botswana Brazil British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Canary Islands Cape Verde Islands Cayman Islands Central African Republic Chad Channel Islands Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia Cuba Curacao Cyprus Czech Republic Democratic Republic of Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador England Equitorial Guinea Eritrea Estonia Ethiopia Faeroe Islands Falkland Islands Federated States of Micronesia Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kiribati Kosovo Kosrae Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Madeira Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Poland Ponape Portugal Puerto Rico Qatar Republic of Yemen Reunion Romania Rota Russia Rwanda Saba Saipan San Marino Sao Tome and Principe Saudi Arabia Scotland Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Korea Spain Sri Lanka St. Barthelemy St. Christopher St. Croix St. Eustatius St. John St. Kitts & Nevis St. Lucia St. Maarten St. Martin St. Thomas St. Vincent & the Grenadines Sudan Suriname Swaziland Sweden Switzerland Syria Tahiti Taiwan Tajikistan Tanzania Thailand Tinian Togo Tokelau Tonga Tortola Trinidad & Tobago Truk Tunisia Turkey Turkmenistan Turks & Caicos Islands Tuvalu Uganda Ukraine Union Island United Arab Emirates United Kingdom United States Uruguay US Virgin Islands Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Gorda Wake Island Wales Wallis & Futuna Islands Western Samoa Zambia Zimbabwe