Springfield Youth Club

1. Springfield Youth Club 2008 BANQUET Springfield Country Club Sunday December 7th 2008 5 pm to 8 pm $25 per adult $15 for Children not Members of the SYC All children in the SYC program are free All Tickets must be purchased by November 21st, 2008 Tickets are also be available at www.springfieldyouthclub.org SYC Members Team Football/Cheerleading Child’s Name ________________________________ _______ _____________________ Child’s Name ________________________________ _______ _____________________ Child’s Name ________________________________ _______ _____________________ Parents Name _________________________ Email _____________________________________ ADULTS # of Tickets Chicken Parmesan ___________ x $25.00 = _________ Prime Rib ___________ x $25.00 = _________ Children SYC Members ___________ x FREE = FREE NON SYC Children ___________ x $15.00 = _________ TOTAL $___________ Checks Payable to: SYC Return to: Michael Spence 42 Thornridge Road Springfield PA 19064 Tables of 10 are available for reservation. Table to reserve under the name of: ____________________ Payment for all attendees must be made in full, at time of table reservation. ALL names of persons occupying the table MUST be listed on the back of this form.

2. 10 People to Reserve Table Name __________________________________________ Name __________________________________________ Name __________________________________________ Name __________________________________________ Name __________________________________________ Name __________________________________________ Name __________________________________________ Name __________________________________________ Name __________________________________________ Name __________________________________________