jG2 Buck Wild Bash
August 18, 2007

Registration

The Lakeland Center
701 West Lime St
Lakeland, FL

Make check or money order payable to:
Kathy Brown
1102 Sagamore Drive
Seffner, Florida 33584

Contact by phone: (813) 661-3054 or E-Mail

Registration can be completed by:

  • Mailing printed registration form and payment to address above
  • Submission of online registration form and $45.00 payment via PayPal


 

 

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jg2 Buck Bash Registration Form

Name:

Street Address:

City:

State: Zip:

E-mail address:

Amount Paid:

I agree to liability terms below:

 
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We, the undersigned, agree to hold the organizers of this event and their agents harmless from all suits, claims, or demands of every kind and character arising out of an in conjunction with this event without limitation. We certify that we are over the age of 18 years. Otherwise, parent or legal guardian signature is required. Signature(s):

Please sign if returning form via mail