Family name, first name : _________________________________
Address
: ______________________________________
City : _____________________________ Prov./State : _______________
Country : _____________________________ Postal Code : ______________
Phone no : (_____)_______________________
If received before September 14, 2007, including activities and meals :
Number
of participants :
__________ x $ 60.00 = ____________
$
Number of children (≤ 10 years old) : __________ x $ 30.00 = ____________
$
Total : ____________
$
If received after September 14, 2007, including
activities and meals :
Number
of participants :
__________ x $ 70.00 = ____________
$
Number of children (≤ 10 years old) : __________ x $ 40.00 = ____________
$
Total : ____________
$
« Association des familles Boisvert Inc. »
39, rue Seigneuriale
Québec QC G1E 4Y3, Canada
Rally (if you are interested, you must register before the
event):
□ Yes, we want to
participate to the historical rally
Teams will be formed at random before the event. Please, write down
participant's names and check children's names who will do it with their
parents. If you are alone or a couple, you will be teamed up with other people.
Names : □ _______________________________
□ _______________________________
□ _______________________________
□ _______________________________
Information : info@famillesboisvert.com
http://www.famillesboisvert.com
(activities details, places to stay,
trip tick)
Suzanne Boisvert
(418) 821-4962