Registration for Winter
Fun Day
Name:
Street Address:
City:
State:
Zip:
E-mail Address:
Cell Phone:
Cell_phone
-
-
Country of Origin:
Gender:
Male
Female
Need Transportation:
none
Other
12:20 PM from Whipple Park (office)
12:30 pm from University Park (bus stop)
12:30 pm from Eastman (in front of Kilbourn Hall)
12:40 p.m. from Goler House (front loop)
1:00 pm Nazereth (library bus stop)
Explain Other Transportation need:
Event :
Winter Fun Day,Saturday Feb 4th, 1pm - 6pm
I understand that the cost is $5 per adult or $15 for a family of 3 or more. I will pay this at the door.
Yes
?
Number of Adults: (0-9)
Names:
Number of Children under age 6: (0-9)
Names:
Number of Children age 6 and older: (0-9)
Names:
Comments :
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