Credit Card Registration

To register your credit card for your event night purchases, please check the box below and then click Next to register your credit card via our secure form.  Your credit card will only be used for your authorized purchases made at this year's Speakeasy Casino Night.  Thank you for your support!

Registration opens: Wednesday, October 1, 2025
Registration closes: Saturday, November 1, 2025

I would like to make a donation

$0.00
I authorize Premier Mobile Health Services Corporation to use the credit card entered on the submission page at event. Once the transaction has completed successfully, a confirmation receipt will be sent to the email address entered.