Revival Raffle

Thank you for partnering with us to bring comfort, hope, and healing to grieving mothers through our August Revival retreat.

Please fill out this form and click submit.

Full name

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Email

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Phone

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Address

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Instagram username (optional)

Red Bird App username (optional)

How did you hear about this raffle?

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Please select one option.

Red Bird Email Red Bird Social Media My local Red Bird Leader

If you heard about this from your local Red Bird leader, please provide their name here (or write "N/A" if this does not apply to your answer)

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Payment

1 ticket ($10.00) 2 tickets ($20) 3 tickets ($30) 4 tickets ($40) 5 tickets ($50) 6 tickets ($60) 7 tickets ($70) 8 tickets ($80) 9 tickets ($90) 10 tickets ($100)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

Thank you for partnering with us to bring comfort, hope, and healing to grieving mothers through our August Revival retreat.

Please fill out this form and click submit.

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