Name ______________________________________________
Mailing Address ______________________________________
City _____________________ State_________ Zip__________
Phone Number _______________________________________
E-mail ______________________________________________
Tentative date you plan to attend: _________________________
Number of Tickets Needed:
_______ @ $15 each (postmarked by April 15) - Total: ________
_______ @ $17 each (After April 15) Total: ________
Shipping & Handling Fee PER ORDER $3.00
USPS Tracking (optional - add $1.00) ________
TOTAL AMOUNT ENCLOSED: $________
Please make check or money order payable to:
"Sharon Grimes", noting it is for "Darien Lake 2012"
.
Mail to:
Sharon Grimes
ATTN: Daren Lake
6469 Frazier Rd.
Moravia, NY 13118-3356