Name *

The name of a Burleith resident, BCA Member or Invited Guest is required.

First Name

Last Name

I am (check all that apply) *

a Burleith resident

a BCA Member

an Invited Guest

Prefer Non-Alcoholic Drink

Hot Mulled Cider will be available for those who would rather not have Gløgg

Yes

No

I am over 21 *

Yes

No

Phone Number

(optional)

(###)

###

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