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LIONS DISTRICT 201 Q4 CONVENTION
Hosted by Rockhampton - Fitzroy River Lions Club Inc.
21-22-23 OCTOBER 2011 Convention Chairman Tim Hannay Email: thann~@merc)lcg.com (M) 0407 313 407 TITLE (PDG etc)
SURNAME
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GIVEN NAME As will appear on your badge
LION LIONESS LEO PARTNER CLUB
DISTRICT:
GUEST
ADDRESS POSTCODE: CONTACT
HOME
EMAIL:
BUSINESS
FAX:
1 ST CONVENTIONEER
--- YES I NO
SPECIAL REQUIRMENTS; o Gluten Free Other Dietary etc:
o Celiac
o Vegetarian
Emergency/Medicallnstructions:
• Dress neat casual for Convention • Theme for DG Banquet - IIRockin and Rewin' in 2011" • Bring your Club Banner
o
Peanut Allergy
...
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PROGRAMME & EVENTS 21 st - 22 nd - 23 rd October 2011
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CLUB:
NAME Date
Event
Details
Cost per person
21-23 Oct
Registration
Convention
$5.00
Friday 21st
Meet and Greet
BBQ Dinner Ticketed Bar
$15.00
Saturday 22nd
Morning Tea
Saturday
$4.00
Lunch
Saturday
$10.00
Lioness Forum (Lunchbox)
Saturday
$10.00
Afternoon Tea
Saturday
$4.00
District Governors Banquet
'Rockin' and 'Revvin'
$45.00
Booking Nos.
Total Cost
Sunday Ticketed Bar Morning Tea
Sunday
$4.00
Lunch
Sunday
$10.00
Friday 21st
Lions Golf (9 Holes) Capricorn Country Club
Friday From 1.30 pm
$15.00
Friday 21st
Lions Social Lawn Bowls Rockhampton Bowls Club
Friday From 2 pm
$8.00 Bowls if Required
Saturday
$Nil
Sunday 23rd
Social Events
Saturdday 22nd Partners Outing Stockland 2pm - 4pm Convention Pin (Limited)
Please tick how Paymentwill be made
$5.50 SUBTOTAL
$
Deduct Early Bird Deposit
-
TOTAL PAYMENT DUE
$
Cheque:
I
Direct Debit
Make your cheque payable to: Fitzroy River Convention 2011 Account Rockhampton Convention 201.1, PO Box 5554 Red Hill 4701 or Post to: Direct Debit to: Westpac Bank: Fitzroy iver Lions Club Convention Account BSB: 034636, Account No: 247186 Email: Secretary Linda MacPherson
[email protected] 