Parent/Guardian Name __________________________________________________________________
Address: _____________________________________________________________________________
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email: ________________________________________ Phone Number: __________________________
Child�s Name Age Exhibit Title
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Please enclose $5.00 per child with a cap of $10.00 per family. Make checks payable to:
Central New England Homeschoolers
Completed and signed registration forms must be received no later than May 15,2007 with full payment. Please mail to:
Patty Mciorowski
172 Minott St.
Gardner, MA 01440
I have read and agree to abide by the Exhibit Day guidelines set forth by the Central New England Homeschoolers. I also agee that by signing this form I have comitted to participating in Exhibit Day and understand that failure you do so may exclude me from participation in any future events.
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Signature of Parent or Guardian Date