NAME___________________________________________________________
.
ADDR___________________________________________________________
CITY___________________________STATE___________________ZIP______
Phone No. ______________Email,(opt)__________________________
Fees -----
Number of Persons - ___,
Adults, $45.00_________,
Total Amount Submitted - ________
Please Make check out to the Buckeye Beemers and mail check and form to:
Buckeye Beemers, PO Box 154, Columbus OH 43216 by Aug. 10th, 2012.
