Tirohanga District 50^th Jubilee

20, 21 and 22 April 2007

REGISTRATION FORM

NAMES: …………………………………………(maiden name if applicable)…………………………

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POSTAL ADDRESS:……………………………………………………………………………………

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PHONE: ……………………… EMAIL:………………………………………………….

Number of people interested in attending Friday evening “Meet and Greet” ……………………

Number of people interested in visiting farms on Saturday ……………………

Number of people interested in helicopter rides on Saturday (Approx cost $60/hd) ……………………

Number of people interested in afternoon tea and welcome on Saturday afternoon ……………………

Number of people interested in having dinner on Saturday evening ……………………

Number of people interested in attending the dance on Saturday evening ……………………

Number of people interested in lunch on Sunday ……………………

Number of History Booklets you would be interested in purchasing (Approx $20 each) ……………….

Registration fee enclosed: ($10.00 per head for those 15 years and over)

($5.00 per head for those under 15 years) $………………….

Have you enclosed any information that could be included in the History Booklet? Yes/No

Accommodation available on SH 1, Atiamuri, at Bees Knees Lodge, Ph 07 333 1718

and Pukeko and Bull Tavern, Ph 07 333 2389

Please post this form with the correct registration fee to: Jillian Martin

376 Oruanui Road

RD 1

Taupo 3377 Phone 07 377 3232

Cheques payable to: Tirohanga Jubilee Account

REMEMBER: This registration and items for the History Booklet must be in by 10 December 2006