Event Details & Registration

First name

Last name

Email

Phone Number

Additional Guests (Please add menu selection in the comment section)

What dessert would you like? Select one.

Assorted cupcakes

Strawberry cake

What would you like to eat? Select one.

Chicken tetrazzini-green beans-corn on the cob-toss salad-roll

Chicken alfredo-green beans-corn on the cobb-toss salad-roll

What would you like to drink? Select one.

Small bottled water and tea

Small bottled water and coke

Small bottled water and diet coke

Small bottled water and fruit punch

Would you like to order a Get Up Sis shirt? If so, the shirt cost $27.50. The shirts are unisex Gildan brand and come in sizes up to 3X. Add size in the comments. Pick up shirt at the event.

Yes

No

*Payment due to hold spot. If you send cash app, please add your name and date choice in the note box. Use the second choice to pay with a credit or debit card. Hover over the link and click it.

$v2vempoweredgems

https://connect.intuit.com/pay/V2vEmpoweredGemsLlc/scs-v1-c400f285e11b4fb497abac4c82f5a34abeb67482f9db401c8e66d7ff72e0939939f8b61df53d4f2995d8fb8ee405e59d?locale=EN_US

Want to add a comment?

Empowerment. Motivation. Inspiration. Growth. Succeed.

1.Add your details

2.Event Policies

Get Up Sis Empowerment Session & Dinner (Nurses, CNAs, PCTs, and other Healthcare Professions)