FOURTH DEGREE PICNICREGISTRATION FORM
WHEN: July 27th at 1:00 p.m.
WHERE: At Roger Daigle’s house on Route 44 in Pomfret (north side of Rte. 44 just west of the “Longmeadow Farms” Subdivision.
MENU: Lobster (if available at a reasonable price), clam chowder, mussels, corn on the cob, potato salad, hot dogs, hamburgers, tossed salad, wine, beer and soda
COST: Basic menu (includes all but lobster) $6.00/person; children 12 and under free; lobster @ $10.00 each. Additional lobsters are available for $10.00 each.
Name of Attendee (Please print or type): ______________________________________
Council No. and location: __________________________________________
Number of attendees over 12 years of age: ________ * $6.00 = $ __________
Number of attendees 12 or under: ________ Free
Number of lobsters ordered: _________ * $10.00 = $ ___________
TOTAL: Attendees __________ Payment: $ ___________
Payment is due by July 11th. Checks must be made payable to “K of C Assembly 114”.
Refunds for cancellations will be allowed until July 20th.
PLEASE BRING LAWN CHAIRS, and bring lawn games if you wish!
CONTACTS: Council 64 – Bob Derosiers or Frank Bichard
We are counting on the above contact people to get a head count of their Fourth Degree members and respective family members who will be attending. The contacts will also be responsible for collecting funds in a timely manner. Please give them your cooperation.
