Gala Reservation Form

Soaring to New Heights Fundraiser Dinner

Every Child, Every County, Every Day
Event Details

Friday, November 7, 2025 • 5:30pm - 8:30pm • The Grapevine Center Las Cruces
NAME*

PrefixFirst NameMiddle NameLast Name
MAILING ADDRESS *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
Number of Guest
Please provide the names of your guests below. No childcare will be provided. Children age 12 and older are welcome.
Name

First NameLast Name
Name

First NameLast Name
Name

First NameLast Name
Name

First NameLast Name
Name

First NameLast Name
Name

First NameLast Name
Name

First NameLast Name
If you are interested in sponsoring a table, please indicate here. We will contact you in person with details.

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Soaring to New Heights Fundraiser Dinner