Hosted by MMKODA

May 6, 2007
12 noon to 5 pm

Black Hill Park
13440 W Old Baltimore Road
Pavillion "C"
Boyds, Maryland

The registration deadline for registration in mail is April 27.

______ $12.00 per adult and teens 12 years and older

______ $8.00 per child 11 years and younger

______ Children 2 and under free

Total $ ___________

______ Put number of vegetarian(s) attending the picnic

PLEASE write down the exact age of your child / children.
This is for the entertainment and game statistics. _________________________________

Name of main ticketholder _________________________________________________

Email address __________________________________________________________

Pager address __________________________________________________________

Address ______________________________________________________________

______________________________________________________________________

Check here _____ if you can volunteer for picnic preparation, clean-up, or events.

Send admission form and money order or check (payable to MMKODA) to:

Send check and form to:
Noel Rivera - MMKODA
11010 Cone Lane
Silver Spring, Maryland 20902

Thank you!