Super Bingo Registration

Email
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Full Name*
First Name Last Name
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Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone*
Email*
Date of Birth*
MM slash DD slash YYYY
Player Card #
What event would you like to attend?*
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What is the best time to reach you?
Bingo or Hotel & Bingo?
- Bingo Entry Only
- Hotel & Bingo Package
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Arrival Date
MM slash DD slash YYYY
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Departure Date
MM slash DD slash YYYY
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Number of Nights
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Need to add a guest?
- No
- Yes
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Additional Guest Details
First Name Last Name
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Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
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Phone
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Email
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Player Club #
Comments or Special Requests:
Please also send me updates on Bingo at the Plaza Hotel & Casino
- Yes
- No

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