Kings Dominion Tickets
Dear Families:
Once again, Cerebral Palsy of Virginia is offering Kings Dominion tickets to families of children with special needs, for the 2007 Season. For a fee of $50, families will receive 4 tickets and a free parking pass. Dates are listed below. Your registration form must be completed and mailed to the CP Office. Dates availability is on a first come, first serve basis. For further information call the CP Office at 497-7474. Please mail your form to Cerebral Palsy by April 15, 2007.
Dates:
April: 1, 8, 9, 10, 11, 12, 13, 14, 15, 29
May: 6, 27
June: 1, 7, 10, 11, 12, 13, 14, 15, 24,26,27
July: 2, 3, 4, 5, 8, 9, 10 , 11, 12, 15, 16, 18, 19, 22, 23, 24, 25, 26, 28, 29, 30, 31
Aug.: All of August-expect for 7,18 & 26
Sept.: 1, 2, 3, 8 , 9, 16, 22, 23, 29 & 30
October: 6, 7, 13, 14, 20, 21, 27
Kings Dominion Tickets Registration Form
Referring Agency:
Child or Adult Family Members
Name:
Age and Disability:
Guardian's Name:
Address: City State Zip Telephone Home Number:
Work Number:
Fax:
E-Mail 1st Choice
2nd Choice
3rd Choice
_Enclosed is my check in the amount of $50 made payable to Cerebral Palsy of Virginia.
_ Please charge the $50 fee to the following card:
Please circle: VISA /MasterCard/Discover
Card Number: Name on Card:
Expiration Date:
Signature:
Please mail form to:
CP of VA 5825 Arrowhead Drive, Suite 201 -
Va Beach, VA 23462
Regina A. Myrick, President <http://us.i1.yimg.com/us.yimg.com/i/mesg/tsmileys2/01.gif> The Ra'Gene Brittnae' Myrick Foundation, Inc. 404 South College Drive Franklin, Virginia 23851 757.562.1721 voice reginamyrick2003@yahoo.com
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