BMX REUNION PICNIC ORDER FORM

Sunday, JULY 24th, 2005
Tickets: Members: $6.00/person
Contact Name    
Telephone #
Email
PAYMENT: Make cheques payable to the BMX PICNIC 2005 and mail your cheque along with the completed order form to:

Trevor De Silva, 872 Kennedy Road, Scarborough, Ontario M1K 2E8

Tel#416 752 7547  
CHILDREN'S MEAL  Age1

Age2

IF MORE THAN TWO PLEASE ENTER THEIR AGES IN THE REMARKS SECTION BELOW

RULES: DEADLINE FOR LUNCH BOOKING - JULY 9TH
FULL NAME Amount 
  BMX MEMBER FAMILY MEMBER MEMBER'S FREIND

($)

  
1)

2)

3)

4)

5)

6)

7)

8)

9)

10)

          TOTAL PAYMENT $

Please see www.bmx2004.com for more information...