Trivia 2012 registration form

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					                    TRIVIA CHALLENGE REGISTRATION FORM
                                                   FRIDAY, MARCH 23RD, 2012

                                                     THE FUN BEGINS AT 7 PM

                                                   OUR LADY OF PEACE HALL
                                                   7021 Stanley Ave, Niagara Falls

                                   Please mail your registration form and payment to:

                                             Niagara Falls Big Brothers Big Sisters
                             MacBain Community Centre 7150 Montrose Road Unit 7
                                        Niagara Falls, ON L2H 3N3

                                          If you have any questions please contact
                                                        Stacey Dean
                                                          sdean13@cogeco.ca

       Please make your cheque payable to: NIAGARA FALLS BIG BROTHERS BIG SISTERS

                        REGISTRATION DEADLINE FRIDAY, March 16, 2012
                                       Please retain this portion for your records
......................................................................................................................................
                                    Trivia Night Challenge Registration Form – 2012

Team Name: ____________________________________________________

Team Member Name:                                                                                                     Amount

                                                                                                                    $ 160.00




                                                                                  Total enclosed $

Contact information (Team captain):

Name: _______________________________________________________________
Address: ______________________________________________________________
Phone # ____________________________                                           Email: ______________________

				
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