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Please print this form and send in with your Cashiers Check or Money Order
made out to:
Carolyn
(Louise) Patterson 20261 Pierson Street Detroit, Michigan 48219 Payment is due by June 4, 2010 Contact
Information Name:__________________________________________________ Address:________________________________________________ Telephone #:_____________________________________________ Attendee
Information Name:_________________ Age: _____ T-Shirt Size:______ Name:_________________ Age: _____ T-Shirt Size:______ Name:_________________ Age:
_____ T-Shirt Size:______ Name:_________________ Age: _____
T-Shirt Size:______ Number of Adults(12 yrs & over) _____ X $135.00= $_______ Number of Children (4-11yrs)_________ X 75.00= $________ Number of Children (0-3 yrs) __________ X $8.00= $_______ |
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