Beach Party Day Trip

PORT BURWELL BEACH PARTY DAY TRIP - Buses 1 and 2 are currently full. Please do not make any payment at this time. If you wish, you may still complete the registration form, and we will place you on the waiting list

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Name *

First

Last

Spouse Name (No spouse Type N/A) *

Choose One *

AGE 55-64 65 years and older Age 18 - 54 Age 17 & under

Phone Number *

Email *

Emergency Contact Name *

Emergency Contact person's Phone# *

# OF VEGETARIANS *

# OF NON-VEG *

Pick up/Drop off Location *

Ajax - DTA Center - 66 Harwood Ave South Scarborough - Walmart Morningside 799 Milner Ave

Comments - Please add all attendees name *

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