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2022 Fryeburg
Registration #4998

Registration Summary

Registration Date: 06/02/2022

Source: online

Who will attend: Both

Attendee #1 First Name: Mark

Attendee #1 Last Name: Kleparek

Attendee #1 Phone: 260-433-9105

Attendee #1 Email: kkram011657@gmail.com

Attendee #1 Current Office Served:

Attendee #1 Last Office Served:

Attendee #2 First Name: Monica

Attendee #2 Last Name: Kleparek

Attendee #2 Phone: 260-458-4127

Attendee #2 Email: Mkkleparek@gmail.com

Attendee #2 Current Office Served:

Attendee #2 Last Office Served:

Home Club: Member at Large - Region 05

Region: Region 05

Big Red Numbers:

Adults: 2

Youth: 0

Children: 0

Address

Street Address 1: 8708 Fortuna Way

Street Address 2:

City: Fort Wayne

State: IN

Street Address 2: 46815

Street Address 2: United States

Guests
First Name Last Name Type
Options/Costs

Number of Rigs: 1

Options
Airstreams
1STCMAA15WJ512016

Amount Due: 0.00

Amount Paid: 695.00

Adults: 2 X $130.00Teen (13-17): 0 X $40.00
Child (4-12): 0 X $0.00Sites: 1 X $435.00
Early Registration Date: $0.00

Reference #:

Payment Type: card

Approved: No

Received Promotion: Yes