Ticket Registration Form

Fill in the form below and make a donation of $50 (per person) to secure your spot at this year's event.

*Seating is first come, first serve, unless you have an organized a table of 8 or 10. To add your guests names at a later date, please send them directly to lynda@communitycarewn.ca

First & Last Name:

Organization/Company Name (if applicable):

Phone Number:

Email Address

SELECT the # of Tickets you are purchasing: (YOU will receive the charitable tax receipt for the full donation amount)

If you are purchasing tickets for other guests, please list their names and contact email if possible.

*IF you have organized a table of 8 or 10 friends, but you are only purchasing your own tickets, please list the other names below.

Since alcohol will be available for purchase, please confirm you are at least 19 yrs. of age.

YES, I am at least 19 years of age.

NO, I am under 19 years of age.

PLEASE RSVP

Count Me In...I would love to join you at Vineland Growers!

Unfortunately, I cannot attend, but I would like to donate to the event in memory of Debbie.

Spam Blocker

Please click PROCEED TO PAY below, where you will be redirected to a secure payment form to make your donation for your tickets & receive your tax receipt immediately.

Select Debbie Ecker Memorial Christmas Fundraiser from the Fund dropdown and enter the amount for number of tickets you are purchasing.

Questions about our programs? Looking to Volunteer?
Contact Community Care of West Niagara today!
View Our Programs Contact Our Team Become A Volunteer