LAKE ERIE BOAT WEEK
"FIRST 100 CLUB"

REGISTRATION FORM
Name:__________________________________________________________________________________
             Last                                                      First                                                       M.I.

Company Name:__________________________________________________________________________

Please list my contribution as "Anonymous":  _____

Address:________________________________________________________________________________
       Street (Include Apt. or P.O. Box No.)              City                                State                  Zip         

Phone Numbers:  Evening: (         )_____________ Day: (          )____________ Fax: (         )____________

E-mail
(required):_________________________________________________________________________               
     
T-Shirt Size:          M     L     XL     XXL        (Circle one)
REGISTRATION INFORMATION:
  • Cost to become a member of the Lake Erie Boat Week "First 100 Club" is $250.00 (U.S. funds);
  • The "First 100 Club" list - from the first to the hundredth supporter - will be designated publicly
    and numerically by the date your registration and check are received in the Lake Erie Boat Week
    office.  If multiple registrations are received on the same day, the listings will be designated
    alphabetically by last name of the registrant;
  • The information you supply below in the registration form is how you will be recognized and
    publicized for your support of "Lake Erie Boat Week;"
  • You will be listed by personal name only - not a business name;
  • There is an option for anonymous supporters, and your listing will be designated "anonymous,"
    but you will still be listed in the order of registration received;
  • If you send in a $250.00 check to be included in this exclusive club, and the club is filled for 2010,
    your check will be immediately returned to the address you supplied on your registration form;
  • If, for any reason, the Lake Erie Boat Week event does not take place in 2010, your money will be
    returned to the person and the address listed below on the registration form.

Print and send this registration form and check or money order for $250.00
made payable to "Lake Erie Boat Week" to:

Janie Vogel
Event Director, Lake Erie Boat Week
24515 Electric Drive
Bay Village, OH  44140

Please make all checks and money orders for $250.00 U.S. payable to "Lake Erie Boat Week."  
Please do not send cash.  
FOR OFFICE USE ONLY:

Date registration received:_______________________________
Club Registration Number assigned:_______________________
Public number assigned:________________________________
Check number:________________________________________
Amount of check:______________________________________
Name on check:_______________________________________
Deposited:____________________________________________
Returned reason:______________________________________