2010

SERIE ACT CASTROL

BANQUET OF CHAMPIONS
SATURDAY, JANUARY 15, 2011
Hotel Quebec Inn
7175 boulevard Hamel Ouest—Ste-Foy, Quebec
1-800-567-5276
4
R Y Social Hour 5:30 pm—Dinner 6:30 pm

UA Please reserve tickets for my group as follows: _______ tickets at a cost of $50 each = $_________
A N
S,J
T UE Name______________________________Division_________________Team #__________________

Address_____________________________________________________________________________

City________________________________State____________________ZIP_____________________

Daytime Phone_______________________________

PLEASE LIST ALL NAMES OF ALL Form of Payment: Please return this form with payment
Credit Card Check Cash
DRIVERS (checks payable) to:
INCLUDED IN THIS Circle One:
ACT
RESERVATION: Visa Mastercard Discover Attn: Darla Hartt
_______________________________________ #_________________________________________ P.O. Box 296
Waterbury, VT 05676
Expiration__________________________
_______________________________________
For your planning, seating is
Card Holder’s assigned, and tables are arranged in
_______________________________________ Name_____________________________________
rounds of 10 per table

Reservations will be honored on a first-come, first-served basis, according to availability. NO reservations will be accepted without payment, and
reservations are subject to immediate cancellation if payment is not honored by the bank. Reservations WILL NOT be accepted over the phone, and
NO TICKETS WILL BE AVAILABLE AT THE DOOR — you must purchase your ticket IN ADVANCE in order to attend this event. TICKETS ARE REQUIRED
FOR ATTENDANCE.