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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 □ MasterCard □Visa Amount $ ..
Card No.□□□□ □□□□ □□□□ □□□□
Name on card .. .
Expiry date □□ □□ Signed
For more information,
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 applicants names on separate registration forms (keep grouped forms together) and let us know who your payment is intended to cover. |
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