Registration Form

KNIGHTS OF COLUMBUS - PILGRIMAGE TO NEW HAVEN

Name - _________________________ Council -               ____________

Address -_______________________  Telephone  (H)      ____________

               _______________________                     (Cell)  __________

Postal Code_____________________   E-mail address     _____________

    1. Names of those going to New Haven (adults).
         ___________________________________
         ___________________________________
    2. I’m planning on bringing _________ children.
    3. I would like to reserve ____spaces for the Saturday evening Dinner.
    4. I have enclosed a Non-Refundable Deposit Cheque of $ _______.

1. All cheques made payable to Kevin Ready – New Haven Trip
2. Initial payment of $50.00 per adult is due on Sept 15th 
3. Final payment of remaining amount is due on October 15th
4. Prepare necessary documents for U.S. entry.

SEND TO:     Kevin Ready, 106 De Monts, Boucherville, Qc. J4B 4K3