Details
Getting There
Honorary Committee
About the Gala
Moores UCSD Cancer Center
Chefs
Featured Wines
Fund-An-Item
Silent Auction
Registration
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Registration Fee $25.00 per person (includes event t-shirt)
Late Registration fee $30.00 (after 10/09/09)
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Please
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Moores UCSD Cancer Center
| 858-822-1328 |
jennilyn@ucsd.edu
| 9500 Gilman Drive #0853, La Jolla, CA 92093-0853