Advance Registration Form – Deadline June 1, 2012
Mail to: Eileen Jeffery, Box 55, Briercrest, Sk. S0H 0K0
Name: __________________________________________
Address: ________________________________________
Additional Family Members: ________________________
________________________________________________
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Registration Fee: Adult $10.00 5 to 12 years: $5.00
4 years & under: free $_____________
**Advance orders will be given priority**
** $5.00 Surcharge/plate after June 1, 2012
** Make cheques payable to Briercrest 100th Anniversary Committee
Saturday, June 30th: 8:00 – 10:00 am – Pancake Breakfast
Includes: Pancakes, sausage, hash browns, coffee, juice
Adults $6.00 ½ Order $3.00 $______________
Saturday, June 30th: 6:00 – 8:00 pm – Supper (Pre-registation ONLY)
Includes: Hot roast beef, gravy, potatoes, seven salads, dessert
Adults $15.00 5 to 12 yrs. $7.50 4 yrs & under: free $______________
Saturday, June 30th: 9:00 – 1:00 am – Cabaret & midnight lunch
Adults $12.00 Family: $30.00 $______________
Sunday, July 1st: 8:00 am– 1:00pm – Brunch
Includes: Quiche, scrambled eggs, bacon, sausage, fruit, desserts
Adults $12.00 5 to 12 yrs. $6.00 4yrs & under: free $______________
TOTAL SUBMITTED: $______________
Cheques payable to: Briercrest 100th Anniversary Committee
Order Form
Hoodie with logo: Colors: Grey, Pink, Blue
Adults: Sizes S to 2XL #_____ Size_______ Color_________x $25.00 = ___________
Youth: Sizes S to L #_____ Size_______ Color_________ x$23.00 = ___________
Toddler: not available
T- Shirt with logo: Colors: Grey, Pink, Blue
Adults: Sizes S to 2XL #_____ Size_______ Color ________ x $15.00 = ___________
Youth: Sizes XS to XL #_____ Size_______ Color ________ x $12.00 = ___________
Toddler: Sizes 2T, 3T, 4T #_____ Size_______ Color ________ x $12.00 = ___________
Total: ___________
Payable to Briercrest 100th Anniversary Committee
Hoodies and T-shirts by pre-orders only, hats and other souvenirs will be available to
purchase at the anniversary.
