Name ____________________________________________ Date _________________
Address _________________________________________ City __________________
State/Zip _________________________ Phone _________________________________
Total Number of tickets _______________
$40[ ] $60[ ] $100[ ] Name ________________________________________ Chicken [ ] or Beef [ ]
$40[ ] $60[ ] $100[ ] Name ________________________________________ Chicken [ ] or Beef [ ]
$40[ ] $60[ ] $100[ ] Name ________________________________________ Chicken [ ] or Beef [ ]
$40[ ] $60[ ] $100[ ] Name ________________________________________ Chicken [ ] or Beef [ ]
$40[ ] $60[ ] $100[ ] Name ________________________________________ Chicken [ ] or Beef [ ]
$40[ ] $60[ ] $100[ ] Name ________________________________________ Chicken [ ] or Beef [ ]
$40[ ] $60[ ] $100[ ] Name ________________________________________ Chicken [ ] or Beef [ ]
$60
fee includes 50 general draw tickes, $100 fee includes 100 general draw tickets.
After
February 1, 2011
add $10
late registration fee
per person
Enclosed is $ _____________ Your Check Number ____________
O VISA O Mastercard # __________________________________ Ex ___________
Bank Card Signature _______________________________________
Cancellations
after February 10th will not receive a refund
Mail Check (payable to: OBH) or Credit Card Info To:
Oregon Bow Hunters
c/o Carol Johnson
PO Box 161
Williamina, OR 97396
cell: 971 237-3099