EmailMe Form - Middlebrook Family Reunion Registration

Middlebrook Family Reunion Registration

PLEASE FILL IN THIS FORM ONLINE AND IT WILL AUTOMATICALLY BE SUBMITTED TO THE COMMITTEE

DATE
Saturday, 24 January, 2015 11.00am-4.00pm
Check In,Reunion Photos, Mix and Mingle and Displays.
Finger food and Tea and Coffee provided.
Cash Bar Available

Sunday, 25 January 2015, 12 midday -3.00pm
Buffet Lunch, Speakers, Cutting of the Reunion Cake
Cash Bar Available

ADDRESS
Fairway Lodge
Silverfield (behind North Shore Events Centre)
Takapuna, Auckland.

ClLOSEST ACCOMODATION OPTION

City of Sails Motor Inn, Shakespeare Rd, Milford
Poenamo Hotel Northcote Road, Takapuna.
Spencer on Byron Hotel Takapuna

YOUR DETAILS
This is where you will fill in your details like name and address .
If you are registering other family members please include them as additional guests
Name *
First Last
Spouse or Additional Guest Name
First Last
Additional Guest Name
First Last
Additional Guest Name
First Last
Additional Guest Name
First Last
Your Phone Number *
Your Email Address
Your Mailing Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Please select which Middlebrook branch you are descended from. *
Comments
REGISTRATION OPTIONS
Please note prices will increase after 30 November 2014. Please select the option you require.
SINGLE DAY EARLY REGISTRATION PRICING OPTIONS

Payment to be made by 30 November 2014
Saturday only. Includes finger food and tea and coffee. $40.00 per person.
Saturday Only Child 0-7 Free
Saturday Only Child 8-13 $10 per person
Sunday only. Includes buffet lunch and tea and coffee. $50.00 per person.
Sunday Only Child 13 and Under $35 per person
FULL 2 DAY EARLY REGISTRATION OPTIONS
$90.00 per adult for full payment by 30 November 2014.
$45 per child 8-13 years
$35 per child 0-7 years
Please detail for whom you are paying and whether you are paying deposits or full payment.
Total Amount being Paid today *
$ Dollars . Cents
Please select how you will make payment. *
Direct credit/ Internet banking to ASB Remuera Auckland. Account number: 12-3030-0779266-50 Please reference your name and code MFR2015.
Cheque made payable to Middlebrook Family Reunion. Post to Jennie Forder, 198A Victoria Avenue, Remuera, Auckland 1050.
Comments
You will receive email or phone confirmation on receipt of your registration fee.

HOW CAN I HELP WITH THE REUNION?
Your reunion committee are looking for any assistance in making this event informative, interesting and pleasurable. To that end if you have any skills which we could call on we would be most excited to hear from you.

Please let us know by selecting here on this form and we will contact you
Audio Visual
Printing
Transport for out of town guests to and from the reunion venue
Making a short presentation or speech at the reunion
Anything else you think may be of use (leave a comment below)
Questions / Comments

EMF Online Form Builder

Report Abuse

YOUR DETAILS

REGISTRATION OPTIONS