REGISTRATION FOR THE MAY 31st MEETING OF THE ASSOCIATION OF THE DESCENDANTS OF ANTOINE BOURG INC

REGISTRATION FOR THE MAY 30th MEETING
OF THE ASSOCIATION OF THE DESCENDANTS
OF ANTOINE BOURG INC.
GOLF AND CURLING CLUB
1 DU GOLF ROAD
THETFORD MINES

Please fill, print and mail with your payment

First Name

Name

Street

City and Province

Postal Code

Phone

E-Mail

Width

and width

Number of children 0 to 5 (free)

Number of children 6 to 17 (10$ each)

Number of adults (25$ each)

Total amount (in Canadian currency)
$

Reservations for saturday evening diner,
(payment at restaurant)

Reservations for Saturday evening Acadian Concert

Make your check to: LES DESCENDANTS D'ANTOINE BOURG INC.
Mail to the following adress:
LES DESCENDANTS D'ANTOINE BOURG INC.
a/s Denis Bourke Désilets
404, rue de Jumonville
Boucherville (Québec)
J4B 1K2

First Name
Name
Street
City and Province
Postal Code
Phone
E-Mail
Width
and width
Number of children 0 to 5 (free)
Number of children 6 to 17 (10$ each)
Number of adults (25$ each)
Total amount (in Canadian currency)	$
Reservations for saturday evening diner, (payment at restaurant)
Reservations for Saturday evening Acadian Concert