Northcentral Maltese Rescue, Inc. Picnic Registration Form
PICNIC DATE Saturday, June 23, 2018
PICNIC LOCATION Racine, Wisconsin
COST $25.00 per person for adults and $20.00 per person for children under the age of 16.
EVENTS Auction, guest speakers, obedience demonstration, pet
photographer, dog painting.
REGISTRATION Use this Form or Click on the PayPal Registration site below
Print this Form for a black and white printer friendly copy
PLEASE NOTE Trudy must receive this form no later than June 18, 2018
DONATIONS Please add a donation to help with veterinary expenses
NAMES OF EVERYONE ATTENDING _________________________________________________________________________
NOTE THE NAMES OF CANINE GUESTS AND INDICATE THE BREED (maximum 20 pounds)
YOUR ADDRESS (city, state and zip code)
YOUR PHONE NUMBER ______________________________________________________________________________
YOUR EMAIL ADDRESS _______________________________________________________________________________
PAYMENT Please reserve space for _______ adults at $25.00 each and _______ children at $20.00 each.
In addition to my registration, I would like to make a tax-deductible contribution to the Rescue of
The total for my registration and donation is: $___________
PAYMENT METHOD Payment Option 1: I am enclosing a check payable to Northcentral Maltese Rescue, Inc.
Send check with a printout of this Registration Form to:
110 Scenic Lane
Ellensburg, WA 98926
Payment Option 2: I am paying through PayPal. To pay by PayPal, follow this link:
After making payment through PayPal, please email the Registration Form