Please RSVP by January 26, 2009
Name _____________________________________
Adults $12.00 Children 3-10 yrs $8.00
Number of Adults
Attending ____________
Number of Children Attending____________
Amount Enclosed______________
Please send form with check payable to NEWApHC to:
Kathy Buth
7850 Sandy Ridge Road
Kewaskum, WI 53040
262.305.0107
___________________________________________________________________