CHRISTMAS BANQUET REGISTRATION 2

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First name

Last name

Address

City

State

Zip Code

Cell phone

Email

Home Phone

Church

If you are registering a group, please list their names and ages (if children) below:

I am attending

Friday Evening (December 10)

Saturday Evening (December 11)

Specifc Diet Requests (must be submitted by the Wednesday preceeding your chosen date):

$

We'll see you soon!

CONTACT:

96 Wanamaker Road
Northfield, MA 01360

Tel: (413) 498-0256

Fax: (413) 498-0276