* * * * Friday, March 31, 2006 * * * *
Contact Name, Address & Phone: ___________________________________________
Team Donation of $180 Each x ________ # Teams = $________________
Full Page Ad with Team Registration - $50 _____________
Full page ad only - $100.00: ___________ (5" x 8" black & white)
** Registration Deadline: March 15, 2006
Please list the names and addresses of each player below. Only the names will appear in the program. Please list the Team Name as you wish it to appear in the program. List names in the order you wish for them to appear.
_____________________ _____________________ _____________________
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_____________________ _____________________ _____________________
TEAM # 2______________________________________
_____________________ _____________________ _____________________
_____________________ _____________________ _____________________
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TEAM # 3______________________________________
_____________________ _____________________ _____________________
_____________________ _____________________ _____________________
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Please mail your check and this form by March 15, 2006.
Make checks payable to:
The Arc of Frederick County
Attn: Beate Frankel
620-A Research Drive
Frederick, MD 21703
MC/Visa also accepted. Call The Arc at 301-663-0909 for information.
Under the IRS Guidelines $120.00 of your $180.00 Registration fee is tax deductible.
Contact Beate Frankel at 301-663-0909 if you have any questions.
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