REGISTRATION FORM:
PLEASE PRINT ALL INFORMATION CLEARLY
NAME: _____________________________________________________________
STREET:____________________________________________________________
CITY/STATE/ZIP:______________________________________________________
PHONE______________________________________________________________
EMAIL:______________________________________________________________
RESERVE____________ SPOT(S) FOR ME AT $20.00 EACH = TOTAL: ___________.
ENCLOSE CHECK PAYABLE TO "ST STANISLAUS PARISH" OR COMPLETE THE FOLLOWING
TO PAY BY CREDIT CARD. CIRCLE THE CARD USED: VISA / MASTER CARD / DISCOVER
CREDIT CARD NUMBER: _______________________________________ EXPIRATION_________
SERCURITY CODE:____________
NAME AS IT APPEARS ON CREDIT CARD:_______________________________________________
MAIL THIS FORM (AND CHECK) TO ANNE FULTZ, 6936 SHOEMAKE AVE, MODESTO, CA 95358
NAME: _____________________________________________________________
STREET:____________________________________________________________
CITY/STATE/ZIP:______________________________________________________
PHONE______________________________________________________________
EMAIL:______________________________________________________________
RESERVE____________ SPOT(S) FOR ME AT $20.00 EACH = TOTAL: ___________.
ENCLOSE CHECK PAYABLE TO "ST STANISLAUS PARISH" OR COMPLETE THE FOLLOWING
TO PAY BY CREDIT CARD. CIRCLE THE CARD USED: VISA / MASTER CARD / DISCOVER
CREDIT CARD NUMBER: _______________________________________ EXPIRATION_________
SERCURITY CODE:____________
NAME AS IT APPEARS ON CREDIT CARD:_______________________________________________
MAIL THIS FORM (AND CHECK) TO ANNE FULTZ, 6936 SHOEMAKE AVE, MODESTO, CA 95358