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Senior Event: Texas State Dinner Theater
Please complete the form for yourself and your spouse (if applicable). If anyone needs help with registration, feel free to have them text or call
972-836-7001
.
Your name
*
Last name
Email address
*
Mobile Phone Number:
*
Please select your dinner choice:
*
Select…
Beef: Country Fried Steak
Chicken: Baked Chicken Breast (Sauce contains ground pine nuts)
Seafood: Garlic Butter Shrimp
Vegetarian: Eggplant Parmesan
Please select your dessert choice:
*
Select…
Key Lime Pie (May contain Nuts)
Marble Chocolate Mouse Cake
Blueberry Cheesecake
Fruit Cup
Are you registering your Spouse?
*
Select…
Yes
No
Emergency Contact and Phone Number
*
Please enter your emergency contact information
Health Concerns/Conditions
Please enter health concerns that you would like to share
Submit
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