Full name*:

Group Name*:

Your Email*:

Phone*:

Fax:

Preferred date*:

Preferred time*:

Alternate date:

Alternative time:

Number of Adult Registrants*:
The VHM can accommodate up to 120 people max.

Number of Students (under 18)*:
The VHM can accommodate up to 120 people max.

Additional Comments:

Please write this number down for reference later:

* = required fields