Formulaire d'inscription

AGA 2002 AGM 

Registration form

                                                                                                                        
Nom/Name:_______________________________________________________________
Adresse/Address:____________________________________________________________
 _________________________________________________________________________
Tél/Tel:__________________________________________
Courriel/E-mail:______________________________________
Nom du Club/Name of Club:____________________________________________________
Coûts/Costs:                                                                                                        Total
Frais d'inscription/Registration Fee:                                                  
Avant le 26 avril/Before April 26  15.00$/pers                                                 (                 )
Après le 26 avril/After April 26:   30.00$/pers                                                 (                 )        
                                                                                                                                                    
Banquet du samedi soir/Saturday night Banquet  25.00$/pers*                         (                )       

*poulet/chichen (___) *saumon/salmon(___) *végétarien/vegetarian(___)                                                                                                                                                            

                                                                                                                                                     

Repas/Boxed lunches  6.00$/pers (samedi/Saturday)                                         (               )                  
Repas/Boxed lunches  6.00$/pers (dimanche/Sunday)                                      (                 )                
Sortie en Kayak/Kayak outing  20.00$/pers (max 22 par sortie/per outting         (                  )                
Canot Voyageur/Voyageur canoe Parc nat.Kouchibouguac Nat. Park  (max 16 pers)                 
Total ci-inclus/total inclosed:                                                                              (                   )
Encerclez vos choix d'activités              Circle your choice of  activities 

 Samedi/Saturday

 -A-  -B-  -C-  -D-  -E-

  -F-   -G-  -H-  -I-   -J-

Dimanche/Sunday

  -K-  -L- -M-  -N-  -O-  -P-

 

Veuillez noter
L'Association des Naturalistes de la Baie de Bouctouche, la FNNB et le Parc Kouchibouguac ne seront pas tenus responsables de tout accident, blessure ou dommage subis par toute personne participant aux activités de la fin de semaine du 31 mai, 1 et 2 juin, 2002.  Nous, sousignés, acceptons de participer à nos propres risques.
Please note
The Association des Naturalistes de la Baie de Bouctouche, the NBFN and Kouchibouguac National park are not responsible or liable for accidents, injuries or damages to persons participating in any of the activities of the weekend of may 31st, june 1st and 2nd. We, the undersigned, accept to participate at our own risk.
Signature(s)_________________________________________________________
Date:____________________________________________
Questions:  506-743-8485 ou/or 506-576-1075 ou/or anbbouct@yahoo.com
http://www.oocities.org/anbbouct/
Chèque ou Mandat Poste payable à: /Check or Money Order payable to:
L'Association des Naturalistes de la Baie de Bouctouche (ANBB)
à l'attention de/ attention:  Marc LeBlanc, trésorier
383, Chemin de la Côte
Grand-Digue, N.B.
E4R 4A9

 

 

AGM 2002 AGA