BearsCanberra Inc.

Christmas in July

Friday 25 July – Sunday 27 July 2008

 

Name:  ________________________________________________________________ 

Address:  _______________________________________________________________

City/Suburb__________________________ State ____________ Postcode___________

Phone_______________________________  Email: _____________________________

Please circle options (1 or any combination of 2, 3 and/or 4)

1           All inclusive  (Fri Meet and Greet/Sat Dinner/Sun Recovery)                YES $

2           Meet and Greet (Friday night)                                                                         YES $

3           Dinner (Saturday night)                                                                                    YES $

4           Recovery (Sunday morning)                                                                           YES $

 

             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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