| Corporation Name: * |
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| Reservation Name: * |
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(as it will appear in the program)
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| Contact Name: * | |
| Address: * |
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| City * |
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| Postal Code: * | |
| Business Phone: * |
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| Residential Phone: * |
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| Fax: |
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| E-mail: * |
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| Reservation Date: * |
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From the 4 options below, indicate your tent/table preference by placing the quantity in the box to the right of the appropriate item
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Corporate Tent (includes 100 Tickets) - $20,000.00
includes:
fully catered lunch buffet, Beer, wine & soft drinks, VIP parking
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Corporate Tent (includes 50 Tickets) - $10,000.00
includes:
fully catered lunch buffet, Beer, wine & soft drinks, VIP parking
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Reserved Table (includes 10 Tickets) - $1,750.00
includes:
fully catered lunch buffet, Beer, wine & soft drinks, VIP parking
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Reserved Table (includes 8 Tickets) $1,500.00
includes:
fully catered lunch buffet, Beer, wine & soft drinks, VIP parking
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| Tickets $15.00 per adult (over 12 years old) X |
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Please provide us with an emergency telephone number in case we have to contact you the morning of or the evening before the day on which you have ordered your table.
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| Emergency Phone: * |
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By submitting this form, the registrant, for valuable consideration and the payment outlined above, hereby agrees with Polo for Heart for the securing of exclusive use of the facilities indicated |
| on the dates outlined above. Your reservation will be confirmed when full payment is received. In case of inclement weather or other Acts of God, sponsors are still liable for their financial and/or |
| donation portion of this agreement. |
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In the next step you will be able to input the number of tickets and pay online |
