Please fill out the order form below. Preregistration is good through May 25, 2019

CIRCNA XXI REGISTRATION

Preregistration
On or before May 25, 2019 (Save $5)
Price Ea.
$
35.00
Item Total
$
0.00
Child Registration
Non-addicts under 18
Price Ea.
$
7.00
Item Total
$
0.00

ENTERTAINMENT

Friday Night Concert - 10pm
Blackout Blues Band
Price Ea.
$
10.00
Item Total
$
0.00
Friday Bingo - 10pm
Price Ea.
$
10.00
Item Total
$
0.00
Saturday Golf Tournament - 6am
Price Per Person (Teams of 4)
Price Ea.
$
80.00
Item Total
$
0.00
Saturday Bingo - 10am
Price Ea.
$
10.00
Item Total
$
0.00
Saturday Night Comedy Show - 10pm
May not be appropriate for kids
Price Ea.
$
15.00
Item Total
$
0.00

PREREGISTRATION MERCHANDISE

Folding Camp Chair*
*Items are subject to change.
Orders must be placed by May 25, 2019

Price Ea.
$
30.00
Item Total
$
0.00
Beach Mat*
*Items are subject to change.
Orders must be placed by May 25, 2019

Price Ea.
$
15.00
Item Total
$
0.00
Raffle Tickets (100)
Orders must be placed by May 25, 2019
Price Ea.
$
50.00
Item Total
$
0.00

NEWCOMER DONATION

Newcomer Donation
Amounts with change will be rounded to closest dollar

REVIEW YOUR ORDER

SUB-TOTAL
$
0.00
TOTAL
$
0.00