Registration
Name _______________________________________________________________________________
School/Library_______________________________________________
County ___________________
School/Library address _____________________________________________City__________________Zip_____________
School/Library phone #______________________ e-mail
address: _______________________________
Please send information on motel accommodations: ___yes
___no
Registration Cost:
$20.00 (includes coffee & donuts
and lunch) .............Lawn chair or blanket recommended
Payment Method: ___Check
(Make checks payable to Broadfoot's of Wendell) ___Mastercard
___Visa
Card #__________ __________ __________ __________
Exp. Date_____/_____
Home address_____________________________________________City________________Zip______________
Signature_____________________________________________
Phone #__________________________
Mail to: Broadfoot's of Wendell, 6624 Robertson Pond Road, Wendell,
NC 27591 or Fax to: (919)
365-6008