Midwestern Ontario District Optimist
Insuring Our Future
Convention Registration  


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

$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

$20.00

Spouse/Guest Name:  


$12.00

Children:

Name

Age

T-Shirt Size

T-Shirts must be worn for all youth activities
$6.00/child




Tickets


Qty

Opening Ceremoniess 

(Friday 7:30pm)

NC

Old Timers Breakfast 

(Saturday 6:59am)

$13.00ea

President 04-05 Luncheon 

(Saturday Noon)

$15.00ea

"Fun in the Sun" Dinner and Entertainment

(Sat. 6pm)

$28.00ea

"Invest in Our Kids"  Luncheon 

(Sunday 11am)

$20.00ea

Partner's Activity Day


$40.00

Youth Activities - Ages 5 to 17

Fri 7:30pm & Sat 9am   

$19.00ea
Registration should be received before June 30, 2004
Registration is payable by cheque and should be made out to  MIDWESTERN ONTARIO  DiISTRICT

 

Hotel Reservation:
4 Points Sheraton, London


Check if you require a room reservation      $99.00 - Regular    $109 - Mini Suite,  $124 - luxury suite    -- plus taxes.

Room Occupancy:     Adults     Children

     ARRIVAL DATE:     TIME
DEPARTURE DATE  

Room Type:  

Smoking
Non-Smoking
Hotel Reservation must be made with Credit Card.