Group Rates

[text* fname class:textbox placeholder “First Name”]
[text* lname class:textbox placeholder “Last Name”]
[tel* phone placeholder “Phone # / SMS”]
[email* email placeholder “Email”]
[text* dob class:textbox placeholder “Date of Birth”]
[select* attendcity id:attendcity class:dropdown “attendcity”]
[text* doevent class:textbox placeholder “Date of Event”]
[text* eventname class:textbox placeholder “Name of Event”]
[text* ticket class:textbox placeholder “# of Tickets”]
[text* budget class:textbox placeholder “Budget”]
[textarea* question placeholder “Questions / Comments”]

[submit “Submit”]

PubCrawl “Group Rates”
Details are mentioned below:

Name: [fname][lname]

Phone: [phone]

Email: [email]

Date of Birth: [dob]

City You Would Like To Attend: [attendcity]

Date of Event: [doevent]

Name of Event: [eventname]

# of Tickets: [ticket]

Budget: [budget]

Questions / Comments: [question]

PubCrawl “[your-subject]”
Message Body:

This e-mail was sent from a contact form on PubCrawl (

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