2009 Community Celebration Registration

April 8, 2010

6:00pm - 8:00pm

Salem Conference Center

200 Commercial Street SE

Please fill in the form below to register for the Celebration event
I will not be able to attend the Celebration event
Your Name * First Last
Company
Email *
Your Address *
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Name- Additional Guest First Last
Guest 1 Email
Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Name - Additional Guest First Last
Guest 2 Email
Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Name - Additional Guest First Last
Guest 3 Email
Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Name- Additional Guest First Last
Guest 4 Email
Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Name- Additional Guest First Last
Guest 5 Email
Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Name- Additional Guest First Last
Guest 6 Email
Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Name- Additional Guest First Last
Guest 7 Email
Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
All guests under the age of 18 must be accompanied by a parent or guardian to this event. Parental consent forms will be required.

Total number of guests UNDER 18 attending *
I'd like to become an event sponsor, please contact me! Volunteer Project Table- $300

2009 Community Celebration Registration

2009 Community Celebration Registration

Please fill in the form below to register for the Celebration event