Group Grip Birkman Order

Please fill in the names and email addresses for each person who will be taking the Grip Birkman. Once this form and payment (via PayPal) for each GB is received, each recipient will be emailed their GB within 48 hours.

Name of Church or Organization
Name 1
First Last
Email 1
Name 2
First Last
Email 2
Name 3
First Last
Email 3
Name 4
First Last
Email 4
Name 5
First Last
Email 5
Name 6
First Last
Email 6
Name 7
First Last
Email 7
Name 8
First Last
Email 8
Name 9
First Last
Email 9
Name 10
First Last
Email 10
Name 11
First Last
Email 11
Name 12
First Last
Email 12
Name 13
First Last
Email 13
Name 14
First Last
Email 14
Name 15
First Last
Email 15
Name 16
First Last
Email 16
Name 17
First Last
Email 17
Name 18
First Last
Email 18
Name 19
First Last
Email 19
Name 20
First Last
Email 20
Total Number of Grip Birkmans Ordered*
Price: $59.00
Total Amount Due
$0.00

Group Grip Birkman Order

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