PACK 28 BLUE & GOLD DINNER 2003 

RESERVATION FORM 

Print this out on your printer and submit with payment to your Den Leader.
If you have more than one Cub Scout in the Pack, fill out one form for each. 
Scouts and family members will be sitting with their dens but if you have more than
 one scout in the pack, you decide which den to sit with.

ALL SCOUTS AND LEADERS TO WEAR UNIFORMS.

DATE: Sunday, March 16, 2003
TIME: 12:30 PM SHARP  
PLACE: Villa Bianca
             Route 34 - Seymour CT
             
PARKING: Ample parking for Villa Bianca is on-site.  
MENU: Buffet served 
Roast Beef Tips, Ziti, Meatballs, Vegetable, Salad, Ice cream, Beverages
COST:  Scouts are free.   Adults and siblings: $11.95 each
Make checks payable to Pack 28. Payments are due to your Den Leader by February  13, 2003
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Pack 28 Blue & Gold Dinner 2003 Reservation Form

NAME:________________________________________SCOUT NAME:________________________

Telephone:__________________________

DEN #:__________  RANK: Circle one:   Tiger     Wolf      Bear     Webelos     Sr. Webelos

Scout        1       X  FREE =  $     0.00     

Adults ________ X  $11.95 = $_________

Siblings________ X $11.95 = $_________

TOTAL----------------------------------$_________

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