Name(s):_________________________________ Telephone No.: (______) ________________
Please list all names so we can make a name tag for every member of your family, including children.
 
 

No. of adults at $16.00 ........................................._________________

No. of Children (age 4-12) at $5.00 ............................._________________

Total Amount Enclosed ..........................................$_________________
 

Make check payable to: Santa Clara Valley Section - ACS

Mail check and reservation form to:
   Sally Peters
   228 Sand Hill Circle
   Menlo Park, CA 94025-7105

Please check if you can volunteer:          ____ I can help set up           ____ I can help clean up