34th DISTRICT 5M4

LIONS MIDWINTER CONVENTION

January 27, 28,29 Alexandria Holiday Inn, Alexandria, MN

PLEASE MAKE YOUR OWN HOTEL RESERVATIONS! Call

Alexandria HOLIDAY INN 320-763-6577 Ask for Lions Convention Rate (95.95 + tax)

IMPORTANT! rooms must be reserved before Jan 6, 2012 or they will be released to the public!!

INDIVIDUAL REGISTRATION FORM

Name________________________________________Club_________________

Name:________________________________________Club__________________

Address:_______________________________________________________________

City:__________________________________State:_________________zip:________________

Phone:_________________________________Email:___________________________________

Guest Children:_______________________________________________Ages___________

++++                 +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ 

EARLY BIRD: CONVENTION PACKAGE (INCLUDES ALL MEALS) BEFORE DECEMBER 15TH, 2011

________@ $70.00 Regular Attendees     ________@ $35.00 First Time Attendee  (what a deal)

________@ $20.00 Children 12 & under   ________@ $50.00 for Saturday only (includes all meals)

REGULAR CONVENTION PACKAGE    (includes all meals)   AFTER DECEMBER 15, 2011

________@ $ 80.00 Regular Attendees      ________@ $40.00 First Time Attendees (Still a Great Deal)

________@ $ 25.00 Children 12 & under   ________@ $ 50.00 for Saturday only (Includes all Meals)

PLEASE NOTE!    NO INDIVIDUAL MEALS WILL BE SOLD ON SITE!!

# OF TICKETS:   INDIVIDUAL MEAL TICKETS:  CHOOSE ONLY IF NO PACKAGE IS SELECTED:

                                 Price      extended amt.

__________ Friday Internationals Director's Reception (Everyone Welcome)   No Charge             

__________ Saturday Kick Off Breakfast......................................$ 20.00.........______________

__________ Saturday Lunch .........................................................$ 25.00.......... _____________

__________ Governor's Banquet Saturday evening ...................$ 35.00 ........______________

__________ Sunday Brunch ..........................................................$ 20.00 ........______________

ALL REGISTRATION MATERIAL MUST BE RECEIVED BY JANUARY 14, 2012

Cancelations after January 14th--------20% Surcharge--- After January 25---Forfeit of payment

MAKE CHECKS PAYABLE TO: DISTRICT 5M-4 LIONS CONVENTION

SEND TO: PDG David Jensen

32549 CO. HY. 11

Wendell, MN 56590

EMAIL: oakstuff@runestone.net

PHONE: home: 218-458-2428 Cell# 218-770-9410

The spouse event this year, will be learning the line dance with the DJ for our evening event. This will be a fun time had by all.

We are offering a Saturday Only Package for $50.00 for those who only wish to attend on Saturday.  This package is a value of $80.00 if you purchased the meals separately. 

*PS, First timers for Dist. 5M4 Lions only.