2010 Father of the Year Luncheon
June 17, 2010
Embassy Suites
1040 P Street
Lincoln, NE

Luncheon Registration
Please fill out the form below to register for the upcoming luncheon. If you prefer to register over the phone, please contact Janet at 402-421-KIDS or toll free at 866-381-KIDS.

Registrations must be received by May 21, 2010 at 10:00 AM CDT.

Tickets for the event are $25 per person for adults and $15 for children 10 and under. Payment for the luncheon will be made at the door the day of the event.

Today's Date*
# of Tickets*
Adults Attending*
(list all attending)
 
Children Attending (if none, please note N/A)*
(list child name(s) and ages)
 
Your Address*
City, State, Zip*
Home Phone*
Work Phone
Email Address*
How did you hear about this event?*
 
Comments/Special Requests
 
Confirmation Code:
Enter the code shown in the box before clicking on submit.

Note: Fields marked by an asterisk (*) are required.