Please include full name, address, phone number and email address for each person registering. If there are others in your party, please indicate so we may seat you together at the TBAI Feast.
Print this page and complete the following information (please print clearly):
Name: __________________________________________________________
Address: ________________________________________________________
City: ___________________________________________________________
State: ___________ Zip Code:____________ Country: ____________________
Telephone #: _____________________ Email: ______________________
____ I/we won't miss the wonderful Thursday evening Gala! Count on me/us to share this very special memorable evening with friends from around the world. Free will donation at event.
Complete TBAI 2010 Convention Activity Package..........................$185.00
Check your choice for Friday morning activity:
____ Visit to Nyala Farm Alpacas in Vestal, NY ____ Nancy Wiley presentation "Creating Wonderland" followed by "Chapeau Challenge"!! _____ I will need a hat ____ I will bring my own hat
Check if you wish to attend Friday afternoon activity:
____ Fun and Games - Flamingo Croquet and more (prizes awarded!!)
Check your choice for the TBAI Feast: (if reg. more than one person and different meals place name on line next to menu choice)
____ Filet Mignon - 8 oz. choicest tenderloin (medium) ____ Greek Stuffed Chicken - Chicken breast stuffed w/spinach and Greek spices topped w/lemon sauce ____ Salmon Scampi - Baked salmon w/mushroom scampi butter sauce ____ Fire Grilled Vegetables served over Rice Pilaf
If you can only join us for part of the activities, please indicate below:
____ Friday morning activities: Continental breakfast, Friday activity (check choice above), and Sabro Square Deli Lunch $65.00 ____ Friday evening activities (please make your feast selection above) $75.00 ____ Saturday Buffet Breakfast $25.00 ____ Saturday evening Cookout at thet Zoo $30.00
Enclosed is a check in the amount of __________ made payable to TBAI.
Charge my Visa or MasterCard (circle one):
Credit Card # _____________________________________ Exp Date: _________ CW2: ________(3-digit # on back of card)
Name as it appears on the card: ________________________________________
Signature of Cardholder ______________________________ Date: ___________
NOTE: All prices are represented in U.S. Currency. To ensure proper exchange rate, please use a credit card outside of the United States.
Mail to: TBAI 4131 State Rte 9 Plattsburgh NY 12901 USA
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