Join in Cornwall’s hottest game night!
Music Trivia Event in support of
Celebrating 25 Years of Service!
Friday, May 12th 2017
6:00 PM - 11:00 PM
AGORA CENTRE (formerly Nativity Hall)
Early Bird Special
Tables of 8 - $320 (that’s a $40 Savings)
If your registration and payment is received by March 31, 2017
(includes pizza dinner, snacks and lots of FUN)
Cash Bar ~ Bake Sale ~ Silent Auction ~ Prizes
There will also be prizes for the winning team and the best dressed team!
Contact Lianne at 613-932-4610 ext 130
or [email protected]
to register your team today. Limited tables available!
Individual Tickets also available for $50 each upon special request.
Special thanks to our partners:
Don't forget there will be prizes for best team costumes!
HOST/ORGANIZATION:
TEAM NAME 1ST CHOICE:
NAME OF CONTACT:
PHONE/CELL:
EMAIL(S):
1
2
NAME:
in support of
TITLE:
TITLE:
ORG:
ORG:
EMAIL:
EMAIL:
ALLERGY / DIETARY RESTRICTION:
ALLERGY / DIETARY RESTRICTION:
3
TEAM PLAYER
FORM 2017
FRIDAY, MAY 12th 2017
6:00 – 11:00 PM
(formerly Nativity Hall)
$360 per table of 8
(Early Bird Special $320)
Kindly complete the form by
4
NAME:
NAME:
TITLE:
TITLE:
ORG:
ORG:
EMAIL:
EMAIL:
ALLERGY / DIETARY RESTRICTION:
ALLERGY / DIETARY RESTRICTION:
5
AGORA CENTRE
NAME:
6
NAME:
NAME:
TITLE:
TITLE:
ORG:
ORG:
EMAIL:
EMAIL:
ALLERGY / DIETARY RESTRICTION:
ALLERGY / DIETARY RESTRICTION:
7
8
filling in all information for
NAME:
NAME:
each player.
TITLE:
TITLE:
ORG:
ORG:
EMAIL:
EMAIL:
ALLERGY / DIETARY RESTRICTION:
ALLERGY / DIETARY RESTRICTION:
Please print/type clearly.
It is extremely important to
note all allergies and/or dietary
restrictions relevant to each
player ASAP.
PLEASE RETURN THIS FORM BY MAY
1, 2017 TO:
EMAIL: [email protected] // FAX: 613-932-5765
*Please note, payment must be received BEFORE the day of the event.
SPECIAL THANKS TO OUR PARTNERS:
Don’t forget there will be prizes for best team costumes!
PLAYER #1:
NAME: _____________________________________________________________
TITLE: ______________________________________________________________
ORGANIZATION: _____________________________________________________
PHONE/CELL: ________________________________________________________
in support of
EMAIL(S): ___________________________________________________________
ALLERGY/DIETARY RESTRICTION(S): _____________________________________
___________________________________________________________________
INDIVIDUAL
PLAYER FORM
2017
FRIDAY, MAY 12th 2017
6:00 – 11:00 PM
AGORA CENTRE
(formerly Nativity Hall)
$50 per ticket
PLAYER #2:
NAME: _____________________________________________________________
TITLE: ______________________________________________________________
ORGANIZATION: _____________________________________________________
PHONE/CELL: ________________________________________________________
EMAIL(S): ___________________________________________________________
Kindly complete the form by
filling in all the information for
each player.
ALLERGY/DIETARY RESTRICTION(S): _____________________________________
___________________________________________________________________
Please print clearly.
It is extremely important to note
all allergies and/or dietary
restrictions relevant to each
player ASAP.
PLEASE RETURN THIS FORM BY MAY 1, 2017 TO:
EMAIL: [email protected] // FAX: 613-932-5765
*Please note, payment must be received BEFORE the day of the event.
SPECIAL THANKS TO OUR PARTNERS: