Team Member # 1 |
Team Member # 2 |
Name: |
Name: |
Address: |
Address: |
City: |
City: |
Province: |
Province: |
Postal Code: |
Postal Code: |
email address: |
email address: |
Day Phone: |
Day Phone: |
$150 - par équipe/ per team • $20 Lunker - par bateau /per boat
Please complete the form and return to the address below
with your cheque or money order payable to the Lefaivre Lions Club. Thank you.
Lefaivre Lions Club, PO Box 190, Lefaivre, Ontario, K0B 1J0