Juneteenth Advance Event Registration
Juneteenth Celebration 2023 will be held at Ida Lee Park in Leesburg, Virginia on Saturday June 17, 2023, from noon to 6 p.m.  Advance ticket sales will open on Saturday, April 1, 2023, through  Saturday, June 3, 2023. Ticket prices will be: $15 in advance and $20 at the gate for all attendees. Use this form for individual and group (up to 11 individuals) tickets purchase. Groups large than 11, please contact Burg Family Reunion for reservation.

If you have more than 15 in your group, you can put two names on one line.  

For more information visit us on the web at https://www.thebfrc.com or send an email to juneteenthcelebrationburg@gmail.com or you can call 704-591-1617
 

See you there!

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Email *
First Name (Enter Name): *
Last Name (Enter below): *
Contact email (Enter below) *
Contact phone number (Enter below) *
Number will be used to contact attendee(s) with any additional information needed to process request. Enter 10 digit phone number without  dashes starting with area code
Number of tickets requested (Enter below) *
Enter the number tickets required include self; tickets prices: Advanced-$15 per person,  Day of the event the price $20 per person
Guest 1 Name: (Enter answer below)
Please add additional guest in your party by First and Last Name. Please do not include self.
Guest 2 Name:
Please add additional guest in your party by First and Last Name
Guest 3 Name:
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Guest 4 Name:
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Guest 5 Name:
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Guest 6 Name:
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Guest 7 Name:
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Guest 8 Name:
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Guest 9 Name:
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Guest 10 Name:
Please add additional guest in your party by First and Last Nam. If additional guest are required please contact BURG Family Reunion Club to make reservation.
Guest 11 Name:   
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Guest 12 Name:   
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Guest 13 Name:   
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Guest 14 Name:   
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Guest 15 Name:   
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Authorized Transaction Amount *
Submit authorized payment amount. Formula: Number of attendees or guest X $15 (5x15=$75), plus processing fees if applicable.
Payment Options *
Attendee is responsible for payment and fees associated with processing payment. Contact us for information about payment processing, cancellation, and/or refunds.
Required
Scan one QR code to pay.  CASHAPP
Scan one QR code to pay.  VENMO
Debit/Credit Card Type
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Name as it appears on Debit/Credit Card 
Debit/Credit Card number
CVV Code   If you are using an American Express Card to pay, please enter the four digit number on front of your card. 
Debit/Credit Card Expiration Date 
Zip Code
I understand advance payments must be received by June 3, 2022 to process payments for event. I understand by submitting this form I hereby authorize Burg Family Reunion Club to process my invoice according to my selection plus processing fees if applicable. *
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