BearsCanberra Inc.

Christmas in July

Thursday 23rd July – Sunday 26 July 2009

 Please register me for BearsCanberra Christmas in July 2009: (one form per person)

 

 

Name:  ________________________________________________________________ 

Address:  _______________________________________________________________

City/Suburb__________________________ State ____________ Postcode___________

Phone_______________________________  Email: _____________________________

Please circle options (1 or any combination of 2, 3, 4, 5,6)         Members      Non Members

1             All inclusive  (Thurs Fri, Sat Sun Events               YES            $160.00                 $180.00 

2             Meet and Greet (Thursday night)                            YES              $15.00                   $20.00

3             Magical Mystery Bus Tour (Friday Day)              YES             $25.00                    $30.00

4                 Dinner (Friday night)                                                  YES          $90.00                  $100.00

5             Dance Party (Saturday Night)                                  YES              $20.00                   $25.00

6             Recovery (Sunday morning)                                    YES              $10.00                   $15.00

            

any special dietary requirements_________________________________

Payment Details:

Please complete your credit card details below
or send your cheque or money order made payable to
BearsCanberra Inc.

                          □ MasterCard               □Visa               Amount $ …………………..

 

Card No.□□□□  □□□□  □□□□  □□□□

 

Name on card    …………………………………………………………………………..……….

 

Expiry date         □□ □□                                         Signed  ………………………………
                          M  M     Y  Y

 

For more information,
                                       email: secretary@bearscanberra.com.au
                                       Telephone (Don or Glen) 02 6253 9828.

 

Please send your completed form/s (one for each registrant) and payment to

 

                                                 The Treasurer

                                                 BearsCanberra Inc,

                                                 GPO Box 1694,

                                                 CANBERRA   ACT   2601

 

You may pay for more that one registration on this form but please fill in the applicant’s names on separate registration forms (keep grouped forms together) and let us know who your payment is intended to cover.

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