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PLC:

a006kq

Agency:

city of clifton arts center and sculpture park

For:

tickets/reservations

Phone:

973-472-5499

Address:

900 clifton avenue
clifton, new jersey 07013

*Required Field

Payment Information

*Reservation Name:

Middle:

*Last:

*Best Can Be Reached Number:

(### - ### - ####)

*Address:

*Email Address:

*Event Selection:

*Ticket Selection:

*Notes/List Names in Reservation:

*If you would like to make a sponsorship payment towards the event, please enter the event name, date, and amount.:

Please calculate total amount from selection(s) and enter into the "Payment Amount" below.

*I authorize that photos or videos maybe taken during the event, which may be published and used to promote the City of Clifton Arts Center & Sculpture Park. Including use on our website and social media platforms.:

Yes

*I release the City of Clifton Arts Center & Sculpture Park from any liability resulting from the use of the pictures.:

Yes

*I understand that the City of Clifton Arts Center & Sculpture Park does not have any medical professionals on site. Staff members will not administer medications and cannot monitor medical conditions.:

Yes

*I understand that in the event of a medical emergency, the Clifton Arts Center staff will seek outside medical assistance and contact necessary relatives. I authorize transportation to hospital and authorize emergency medical treatment.:

Yes

*For refunds, 5 business days before the event date are needed, plus a $5 fee to undo the reservations/ tickets so that a refund can be received.:

I Understand

*The person requesting the refund has to send an email to: rcammilleri@cliftonnj.org and then call to confirm at 973-472-5499. When requesting the refund, please specify the purpose of the cancellation.:

I Understand

Payment Amount

Payment Amount :

Subtotal:

$0.00

Total:

$0.00

Billing Information

*First Name:

Middle Initial:

*Last Name:

*Billing Address:

*City:

*State/Province:

*Zip:

*Country:

*Phone Number:

*Credit/Debit Card:

(enter the full card number without any dashes or spaces)

*Expiration Date:

*Card Security Number:

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