Midwestern Ontario District Optimist
Live Life with Enthusiasm, Focus on the Kids
23nd ANNUAL CONVENTION Registration Form
Hilton Downtown - London, Ontario
August 21, 22, 23, 2009

 


Complete the following to Register :

Ribbons (check all that apply) Cost
Member Surname:*

First Name:

Phone:*

E-Mail:*

Club Name:*

Zone:

First Timer
President
Pres Elect
Secretary
Treasurer
OIF Club Rep
Life member
Lt Gov
Lt Gov Elect
Past Gov
Past OI VP
District Chair

 

$20.00

Member Surname: 
First Name: 
 Phone: 
 E-Mail: 
 Club Name: 
 Zone: 
First Timer
President
Pres Elect
Secretary
Treasurer
OIF Club Rep
Life member
Lt Gov
Lt Gov Elect
Past Gov
Past OI VP
District Chair

$20.00

Spouse/Guest Name:  


$13.00

Tickets


Qty

Opening Ceremoniess 

(Friday 7:30pm)

NC

Fellowship Breakfast 

(Saturday 6:59am)

$15.00ea

MWO District Luncheon 

(Saturday Noon)

$15.00ea

"Focus on Kids" Banquet

(Sat. 6pm)

$30.00ea

"Focus on Kids" Team Luncheon 

(Sunday 11am)

$15.00ea

Partner's Activity Day


$25.00
  Total $

Registration is payable by cheque and should be made out to  MIDWESTERN ONTARIO  DISTRICT

 

Hotel Reservation:
Hilton Downtown
300 King St. (off Wellington St.)
London, ON N6B 1S2

Check if you require a room reservation  

 

Choice of Rooms: BedType:
Room Occupancy: Adults: Children:

     ARRIVAL DATE:     Check in Time is 3pm

DEPARTURE DATE   Check out Time is 12 noon

Wheel Chair Access

Non-Smoking

All rooms are Non-Smoking.

Since this is not a secure site,  you will be asked to submit your Credit Card information to reserve your room when you mail in your cheque for your registration fees. 
Rooms are limited, and assigned of a FIRST COME, FIRST SERVED BASIS, so Book early.

All Rooms must be booked through the Convention Registrar.
Anne Van Niekerk,
5525 King St. RR2,
Wellesley, Ont. N0B 2T0