Is your name Casey? *

Only women named Casey can sign up

Yes

No

Name *

First Name

Last Name

Phone

Only if you're comfortable giving this out

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Activities *

Choose all activities that are of interest

Thrift shop outfit swap

Skee-ball tournament

Storming the Capitol to see how they like it

Desired Date

MM

DD

YYYY

Feedback *

We are are grateful for your feedback

John is clever for this one

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree