Northcentral Maltese Rescue, Inc. Maltese Picnic 2012 Registration Form

DATE:  Saturday & Sunday, June 23 & 24, 2012

LOCATION:  South Beloit, IIlinois (the address will be sent to you as soon as I receive your information)

COST:          $35.00 per person, whether you attend 1 day or 2 days

EVENTS:      Raffle, Auction, Special Guest Speaker, Photographer, Demonstrations - All Fun!

REGISTRATION

Please sign me up for _______ people to attend the 2012 Maltese Picnic.

Please save _____ Gift Bags for us (me). (If no number is specified, you’ll receive ONE Gift Bag)

Payment Worksheet: _______ people  X  $35 each =  $_________

_____ I'm paying through PayPal and will email this form to Trudy  (tpeischl@fairpoint.net)

  Go to    http://malteserescue.homestead.com/PayPalPicnicPayment.html

  There is a $1.50 service charge per attendee to pay by PayPal

Name, mailing address, phone number & email address of each person attending

               Name:    Name:

       Address:      Address:

City/State/Zip:    City/State/Zip:

Phone Number: Phone Number:

Email Address:  Email Address:

         

Breed & Name of each attending canine guest

Attendee Biographies

At the picnic, we will distribute a compiled list of names, mailing addresses, email addresses of all attendees, with names of their canine guests, along with a paragraph or two about each family member. Please check here _______ if you DO NOT wish your mailing address, phone and email address placed on the list (but still wish to receive the compiled biographies).

Please send your paragraphs to: Barb Sambataro at barbsamba@yahoo.com   Deadline for receiving the bios is June 18.

We encourage everyone to join us on Sunday for a relaxing day

After payment is received, picnic address, a map and additional information will be sent to you by email closer to the time of the picnic. All proceeds after expenses will be donated to Northcentral Maltese Rescue, Inc.

Sorry, no breeders.