NOTE: For faster service, check the schedule and select the event you wish to register for.

You will be charged $40 to register for a Simi Speed Dates event!

Name:
Address:
City:
Zip Code:
Email Address:
Phone:
Date of Birth:
Age:
Gender: Male Female
Contact Preference Phone Email
Credit Card Type:
Card Number:
Expires On:
3 Digit ID:
(The 3 digit number on the back of your card on the signature line)
  I have read and agree to the Terms and Conditions
 

 

Match.com

American Express

 

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