Serenity by the Lake - 2011
September 30 - October 2, 2011

To register for this event print this form, fill out, and mail to:

Serenity by the Lake 2011

PO Box 2114

Page, AZ 86040

Registration is $12.00 per person, this includes Saturday night dinner, children under 12 dinner tickets are $6.00

Make check out to "Serenity by the Lake 2011"

Names of persons registering @ $12.00 each                 
     ________________________________

     ________________________________

     ________________________________

     ________________________________                              _____      @ $12 each $ ____________

Names of persons registering @ $6.00 each

     ________________________________

     ________________________________

     ________________________________

     ________________________________                              _____      @ $ 6 each  $____________

Colorado River Raft Trip (registration must be received on or before Sept 15, 2011)

($65.00 per person)

Names of persons registering for river trip @ $65.00 each, children welcome!

     ________________________________

     ________________________________

     ________________________________

     ________________________________

     ________________________________                             _____    @ $65 each   $ ___________

                                                                                                    Grand Total =   $ ___________

YOUR PHONE _____________________

YOUR EMAIL ______________________________________

(To confirm reservations)

The raft trip leaves by bus on Friday September 30th from the Colorado River Discovery Store at 130 6th Ave. in Page, AZ. Be at the store at 12:30 PM to check in. The bus returns to the store at 6:30 PM. Bring a lunch or snack. Soft drinks will be provided.

WEAR A HAT, AND BRING A WINDBREAKER OR SWEATSHIRT.

SERENITY BY THE LAKE

PO BOX 2114

PAGE, AZ 86040