The Glitz RSVP

Reserve Now, Pay Later

Please use the form below to submit your reservation for The Glitz:

The Glitz Reserve Now, Pay Later

Name

First Name

Last Name

How many seats are you reserving today?

Are you reserving seats for others?

If you are purchasing multiple seats or seats for other people, please list their names below.

Are you joining a reserved table?

If you are paying for a seat at a reserved table, please type the name of the table below.

Phone

(###)

###

####

Email

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Additional Comments

Having Issues?

If you have any difficulties filling out this form, just give us a call or send us a message and we'll get help complete your registration: Tracy Geisler geislert@gchks.org Direct: (785) 210-3365

Once your registration has been submitted, you will receive an invoice in the mail.

If you would prefer to pay online today, please visit our pay online today page.

Reserve Now, Pay Later

Looking for Lodging Options?

Geary Community Healthcare Foundation

Tracy Geisler

Geary Community Healthcare Foundation

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