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Schurch Family Association of North America (SFANA) Reunion
August 10-12, 2012
Registration Form-Please type or print
Return no later than July 15, 2012
Mail Registration Forms and checks to: Laurine Mills, 1750 Killaly St. E., Port Colborne, Ontario Canada L3K 5V3
Name: ____________________________________________ Family code if known:______________
(Last) (First)
Address: _____________________________________________________________________________
(Street)
______________________________________________________________________________
(City) (State or Province) (zip /postal code)
Email: ____________________________________ Phone: ( ) _________________________
Additional names of those covered by this form (include ages if children):
_________________________________________________ __________________________________________________________
_________________________________________________ __________________________________________________________
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Fee for Facility Use/person |
$20.00 x |
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$ __________ |
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Children under 15 Free |
$00.00 x |
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$ __________ |
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Lunch on Friday |
$ ____ x |
_______ |
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$ __________ |
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Children ages 6 – 11 |
$ ____ x |
_______ |
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$ __________ |
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Dinner on Friday |
$ ____ x |
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$ __________ |
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Children ages 6 – 11 |
$ ____ x |
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= |
$ __________ |
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Lunch on Saturday |
$ ____ x |
_______ |
= |
$ __________ |
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Children ages 6 – 11 |
$ ____ x |
_______ |
= |
$ __________ |
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Dinner Banquet on Saturday |
$ ____ x |
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$ __________ |
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Children ages 6 – 11 |
$ ____ x |
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$ __________ |
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Tours to __________________ |
$ ____ x |
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$ __________ |
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Children ages 6 – 11 |
$ ____ x |
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$ __________ |
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(Includes Bus, Admission and Guide) |
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Tour of ___________________ |
$ ____ x |
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$ __________ |
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(Includes Bus, Admission and Guide) |
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Tour of ___________________ |
$ ____ x |
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= |
$ __________ |
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(Includes Bus and Admission) |
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TOTAL |
Can$ or US$ |
$__________ |
I will be bringing an item(s) for the auction. __________ I plan to join the golf outing __________
I cannot attend but am contributing $__________ toward expenses.
Checks payable to SFANA. If you have questions call Laurine at ___________ or send email to:
esthermills@aol.com.
Cancellations must be received by Aug. 3.
Direction to Reunion Site
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