Individual Registration

Please enter information in the form below to process registration for event Fuego Thrusdays at La Terraza.

Ticket Type	Price	Quantity
Club Night Ticket Half Price Entry - for after 8.30pm	£2.50

First Name *

Last Name *

Address

Address 2

City

Post Code/Zip

Country

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Phone

Email *

Comment

Amount

Payment Processing Fee

Gross Amount

Payment Method *

Debit/Credit Card

Credit or debit card*

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