Knights of Columbus, Fourth Degree Rt. Reverend Msgr. Jean C. Mathieu Assembly 114 64 Providence Street Putnam, CT 06260   2011 FOURTH DEGREE PICNIC REGISTRATION FORM   WHEN:  Sunday, July 31 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, clam chowder, mussels, corn on the cob, potato salad, hot dogs, hamburgers, tossed salad, wine, beer and soda.   COST: Basic menu (without lobster) $10.00/person; $13.00 (including lobster), children 12 and under free without lobster.  Family maximum of $40.00, applies to family members living in the same household and no more than two lobsters. Additional lobsters are available for $9.00 each.   Name of Attendee (Please print or type): ______________________________________   Council #.and location: __________________________________________   Number of attendees over 12 years of age: ________ X $10.00 = $ __________  or X $13.00   Number of attendees 12 or under: ________ Free   Number of additional lobsters ordered: _________ * $9.00 = $ ___________   TOTAL:          Attendees __________                        Total Payment: $ ___________   Payment is due by July 15th. Checks must be made payable to “K of C Assembly 114”.   Refunds for cancellations will be allowed until July 18th.   PLEASE BRING LAWN CHAIRS, and bring lawn games if you wish!   CONTACTS:   Dave Meunier Sr (928-4525)   The contacts will also be responsible for collecting funds in a timely manner. Please give them your cooperation.