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Name

Email Address

Number of Adult Dues $165 (Ages 18-64)

Number of Senior Dues $100 (Ages 65+)

Number of Older Children Dues $110 (Ages 12-17)

Number of Child Dues $50 (Ages 6-11)

Small Children $0 (Ages 11 & under)

Please list all your attendees and their ages.

Please, order your Tee-shirts below. All sizes are $20 each.

Adult X-Small Tee

Adult Small Tee

Adult Medium Tee

Adult Large Tee

Adult X-Large Tee

Adult XX-Large Tee

Child's Small Tee

Child's Medium Tee

Child's Large Tee

Child's X-Large Tee

Total Attendees

Total Cost

$

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