Induction Ticket Order Form

+1 506 756 2110

5 Hooper Lane, Petitcodiac, NB

Please use the following form to order and pay for tickets to the 12th Annual Maritime Motorsports Hall of Fame Induction Dinner & Ceremony where we will welcome our Class of 2017 as honoured alumni.

Date: Saturday, November 18, 2017

Time: Meet & Greet at 5 p.m.; Dinner at 6:15 p.m.; Induction Ceremony at 7:30 p.m.

Dress Code: Semi-Formal

Place: Loyalist Country Inn, 195 Moyse Drive, Summerside, PEI

Rooms: Call hotel at 902-436-3333 or 1-800-361-2668; block rate is $101.00 to $110.00; limited availability.

To pay for tickets by cheque, money order, or e-Transfer please download and use the form attached to this link.

Ticket Order Contact Name *

First

Middle

Last

Address *

Address Line 1

City

State / Province / Region

Postal Code

Country

Daytime Phone *

Mobile Phone

Email *

Confirm Email

Number of Tickets ($80.00 each, tables of eight) *

use the drop-down menu above to select the number of tickets you are purchasing

Please List Your Guests *

name tags will read as indicated in this list, so please be accurate

Ticket Delivery *

Mail (deadline is November 1)
Hold for Pickup

Total *

$0.00

Your credit card will be charged this amount when you submit the form.

Credit Card *

Card Number

Security Code

Name on Card

Expiration/

Form Submitted By *

First

Middle

Last

must be 19 or older

Captcha *

if you see a * in the equation it means to multiply

Your order and payment will be processed when you click submit. Please be patient while processing and do not resubmit or terminate. A successful order will result in a thank-you message and receipt of two emails (one for payment and one with your order). If there are errors in your order they will be indicated on the order form - correct and resubmit.

Phone