Labor Day Reunion
The Choconut
Reunion 2002 Reunion Registration Form
Reunion Registration
Form
Please fill out and mail by August
15, 2002 to:
Steve
Perrin
1497 Scio Ridge Ct.
Ann
Arbor, MI 48103
Name__________________________________________
Address
________________________________________ Address
________________________________________ Phone Number
___________________________
____
I plan to attend the Choconut Foundation Get-Together on August 30th, 31st, September
1st
& 2nd,
2002. I will gladly pay $50.00 for this great weekend.
____
Besides myself, I will be bringing ____ guest(s) at the tremendous bargain
of
$50.00 each; ____ children under 2 are free!!; ____ children
ages 2-5
are $10.00; ____ children 6-12 are $25.00; ____ children 13
and up $50.00.
Enclosed is my total check for $______.
I will be
arriving in time for: ____ Friday Dinner, ____
Saturday Breakfast,
____ Saturday Lunch, ____ Other _____________.
_____
I forgot to pay my dues for 2002, $10.00, so I have enclosed them here.
I know my dues are
used to offset printing and postage costs of the CC
Foundation Newsletter.
_____ In
addition to my dues, I would like to help increase the scholarship fund to send a child
to
Camp
Susquehannock.
I have
added an additional $______ to my check.
Preliminary T-Shirt Order Form
If we get over 25 interested buyers we will order CC t-shirts! Return your registration early enough and you might have a t-shirt waiting for you at the reunion. High quality, short sleeved, grey t-shirt, the Choconut bell and “Choconut Foundation” on front left pocket, blank back. Price not finalized; should be around $15 with profits going to the Foundation. Please indicate number desired next to size.
small ___ medium ___ large___ XL ____ XXL ___ Please fill sign the
General Release and Hold Harmless Agreement (below).
.
(Page
Two)
----------------------------------------------------------------------------------------------------
Please fill out and mail with payment by August
15, 2002 to:
Steve
Perrin
1497 Scio Ridge Ct.
Ann
Arbor, MI 48103
General
Release and Hold Harmless Agreement
I/We, the undersigned, for myself/ourselves and for my/our children under
the age of 18, intending to be legally bound, and in consideration for
permission to camp on private property located at and around LAKE CHOCONUT,
FRIENDSVILLE, PA, over Labor Day Weekend 2002, do hereby RELEASE AND
FOREVER DISCHARGE AND AGREE TO HOLD HARMLESS: CAMP SUSQUEHANNOCK
FOR GIRLS, its owners, Edwin H. Shafer and George C. Shafer Jr., its Board of
Directors and members, its employees
and all others in any way connected with the operation of the Susquehannock
Camps, as well as The Lake Choconut Association, its members and officers,
The Choconut Foundation, its members and officers, and heirs, executors,
and administrators of each and every one of them, from ALL MANNER of suits,
or claims for damages or liability for injuries or accidents, which I/we,
my/our children or guests, executors or administrators hereafter
may have, by reason of any matter which may arise out of my/our use of
equipment or facilities at the private property which I/we have been granted
permission to use, or which in any way occurs during my/our attendance
at the Labor Day weekend activities conducted by THE CHOCONUT FOUNDATION.
DATED ______________________, 2002
SIGNED
BY ADULT MEMBERS AND GUESTS:
___________________________________________
___________________________________________
___________________________________________
___________________________________________
PRINT
NAMES & AGES OF CHILDREN UNDER 18 YRS OLD:
1.
_________________________________________
2.
_________________________________________
3.
_________________________________________
4.
_________________________________________
.
.
.
 Home
|
 Newsletter
|
 Photographs
|
 Contact Us
|
|