30 October Red Swan Pizza Lunch

Last Name / Nom de Famille

First Name / Prénom

Service Number / Numéro de Service

Rank / Rang

E-mail

Phone Number / Numéro de Téléphone

Member Status / Statut du Membre

Meal Option / Choix de Repas

Hawaiian Pepperoni Three Cheese Spinach BBQ Chicken

Individual Pizza's

Cost / Coût

Member - $5 Non-Member - $15

Acknowledgement that $5.00 will be deducted from the members pay if the meal is not picked up between 30 October 11:30-12:30 in the Oak Bar

YES / Oui

Consent agreement

By registering to this program or activity, I consent to the collection and use of my personal information as described in the privacy notice above.