Clarke County Athletic Hall of Fame Brunch

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RESRVATION FORM

Clarke County Hall of Fame “Athletic Memories” Brunch

Saturday, OCTOBER 23, 2010 at 9:30 AM

Ruritan Building, Fairgrounds, Berryville, VA

We absolutely need your response ASAP.   Food is being catered by the Ruritan Club and the quantities need to be prepared in advance…Thank you for your immediate attention!

Make checks payable to CC HOF.

Mail completed lower portion of this registration form and check to the following address in order that it will be received by Friday, October 15:

CC HOF Brunch

ATTN:   Fran Combs

249 Cameron St.

Berryville, VA     22611

For information or questions, please call Charlie Ramsburg at 336-240-5511 or email him at clramsburg@hotmail.com.

Cut Here – Return this Lower Section with your Payment by Check

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(Deadline for registration is Friday, October 15, 2010 – Actual Receipt required by that day)

Name: _______________________________________ High School Class Year: ______

Address: ________________________________________________________________

City: ______________________________ State: _____________ Zip-code: __________

Telephone Contact Number (_____)____________________

Email address (if regularly used) ________________________________________

Name(s) of Spouse/Partner/Guests attending: ________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

No. of people attending10/23Brunch ____ X $10 = $ ________(Total of enclosed check)

Brunch -$10 per person – 9 AM on Saturday, October 23, 2010 – Ruritan Building, Fairgrounds, Berryville, VA