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FALL FROLIC 2012
Registration Form
REGION
ONE JCI SENATE FALL FROLIC
October
19 – 21, 2012
The
Margate on Winnipesaukee
76 Lake Street
Laconia, New Hampshire
1-800-MARGATE
*********************************************************************************************************
Hosted by the New Hampshire JCI Senate
Name
________________________________________ JCI
Senate No. _____________
Spouse’s or Guest’s Name
__________________________JCI Senate No. ____________
Mailing Address
____________________________________________________________
City _______________________________ State _______ ZIP Code _________________
Tel. No. ____________________ E-Mail Address(opt.)____________________________
No. of People TOTAL
______ Friday Hospitality…$18.00 pp
Sat. Hospitality ….$23.00 pp $_________
_______ Saturday Luncheon….$25.00 pp $_________
_______ Three Day Package: Fri. Hospitality, Sat. Hospitality, Sat. Luncheon
$ 65.00 per person …………………………………… $ _________
________ Two Day
Package: Saturday Hospitality, Saturday
Luncheon
$
48.00 per person ……………………………………. $ _________
_______ Off-site lodging
surcharge: $25.00 per night $
_________
REGISTRATIONS POSTMARKED AFTER
10/1/2012 …..add $10.00 pp $________
Make
checks payable to: NH JCI SENATE
(Amt. of check - USD) $_________
I’m sharing a room with
______________________ from __________
NOTE: Room reservations should be made directly with the
Margate on Winnipesaukee at
1-800-MARGATE or at reservations@themargate.com.
Identify yourself as Group Code: JCI1019. Rates will be $99.00 (+tax/night) for
Fri./Sat. Reservations for Thurs. and Sunday
should be made with the Margate and will be
$89.00(+tax/night). There will be an
additional charge of $15.00 (+tax/pp/night) for more than two in a room. Lakeview rooms are
guaranteed until September 24, 2012. If you include your e-mail address on this
form, a registration confirmation will be sent to you. Please retain it until your arrival.
____ Check here if SPECIAL NEEDS are required
(specify) ____________________________
____ Check here if this is
your FIRST Region One JCI Senate Fall Frolic
Event
Inquires: Colette Welch, #69240,
Chairperson @ 781-272-9116 or welch38@verizon.net Registration Inquires: Charlie Welch, #11719, @
603-339-2969 or charliewelch@usjcisenate.org
RETURN THIS FORM WITH YOUR CHECK TO: Charlie Welch, #11719
17D Dinsmoor Point Road
Gilford, NH 03249-7625 1/12/12 (Vers. 4)
