New Registration Form

Registration Form Port Kirwan Come Home Year 2010 "This is our Home" th August 5 – August 9th th

Complete this form and mail with payment to address below before June 30 , 2009 or If you are NOT attending, please sign and return form to committee and your name will be removed from our mailing list. Price for each Registration includes Souvenir printed T-Shirts, Program booklet, Personalized name tags and a Small keepsake of “Port Kirwan Come Home Year 2010”. REGISTRATION FEES: Adults (19 up) - $20.00 Youth (13 – 18) - $10.00 Children (3 - 12) - $5.00 Infants (2 and Under) - Free (Please print all names clearly for name tags. Feel free to use the back of the sheets for extra information.)

Your Name:

(maiden Name if applicable)

___________________________________________________________

Full Mailing Address: ______________________________________________________________________ ______________________________________________________________________ Will you be attending “Port Kirwan Come Home Year 2010”

Phone: (

) ____________________

# Attending in family ________

□ YES

□ NO

Email Address: ______________________________________

*Would you or any others in your family be interested in volunteering Yes______

No______

List names of others in your family that will be attending, and relationship (spouse, partner, daughter, son, guest, etc.): 1.______________________________________________________________________ 2.______________________________________________________________________ 3.______________________________________________________________________ 4.______________________________________________________________________ 5.______________________________________________________________________ (If you have children please list their ages.) * Please use back of sheet to list any extra family or volunteering information.

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“Registration Cost Form” Registration

# Attending

Cost

Infants 2 and under

Free

Children 3 – 12

$5.00

Youth 13 – 18

$10.00

Adult - 19 and up

$20.00

Total Cost for Family Cost of Extra T Shirts (If Any) Red Form below is for extra T-Shirt information Total Amount Enclosed

Sub Total

$ $

$

One T Shirt is included for each individual registered – Fill in Quantity and Sizes below (If you have registered 6 family members then you should have 6 T-Shirt sizes filled in on the below chart)

T Shirt Size

Quantity

YOUTH CHILD 2 -4 (SM) Youth 6 – 8 (MD) Youth 10 – 12 (LG) Youth 14 – 16 (XL) Youth 18 – 20 ADULT ADULT Small ADULT Medium ADULT Large ADULT X Large ADULT PLUS ADULT XX Large ADULT XXX Large

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If you need extra T-Shirts or even if you are not planning on attending the Come Home Year but would still like to have a souvenir shirt, please fill in the below chart Prices for ordering Extra T Shirts: Youth Sizes - $8.00 Adult - $12.00 Adult Plus - $14.00 Check the sizes and quantity below and just add in the cost in the space provided* on the Registration Cost Form on Page 2.

T Shirt Size

Price

Quantity

Total

YOUTH CHILD 2 -4 (SM) Youth 6 – 8 (MD) Youth 10 – 12 (LG) Youth 14 – 16 (XL) Youth 18 – 20 ADULT ADULT Small ADULT Medium ADULT Large ADULT X Large ADULT PLUS ADULT XX Large ADULT XXX Large

$8.00 $8.00 $8.00 $8.00 $8.00 $12.00 $12.00 $12.00 $12.00 $14.00 $14.00 TOTAL

Mail completed form with money order to:

Port Kirwan Come Home Year 2010 "This is our Home" Site 2, P.O. Box 30 Port Kirwan, NL A0A 2G0

Please feel free to contact any member of the “Come Home Year” Committee If you have any questions or concerns: Carol Ann O'Neill : (709) 363-2525 , Gerald O'Neill : (709) 363-2525, Vianne Chidley : (709) 363-2516 Kristina Fennelly : (709) 363-7530, Gen Kenny: (709) 363-2842 E Mail Address: [email protected] Web Site: http://www.freewebs.com/port-kirwan/

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