Bicentennial Reservations

RESERVATION FORM

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Do not send your check now. Print out and complete this reservation form and mail to:

West Brookfield Historical Commission

P.O. Box 372

West Brookfield, MA 01585

Name: _______________________________

Address: _____________________________

_____________________________

Email: _______________________________

Phone: ______________________________

Please check your preferred method of communication

Email

Phone

Below please enter the number of people who plan to attend each event:

SATURDAY, August 11, 2018

LUCY STONE BIRTH SITE BUS TOUR

__ Adults ($5.00) __ Students 8-14 ($2.50)

BIRTHDAY CELEBRATION SUFFRAGIST TEA

__ Adults ($5.00) __ Students 8-14 ($2.50)

CONCERT OF PERIOD SONGS

__ Adults ($5.00) __ Students 8-14 ($2.50)

SUNDAY, August 12, 2018

I NOW PRONOUNCE YOU LUCY STONE AND A CONCERT OF PERIOD MUSIC

__ Adults ($10.00) __ Students 8-14 ($5.00)

ROUND TABLE PANEL DISCUSSION

__ Adults ($5.00) __ Students 8-14 ($2.50)

The Commission will notify you by email or phone on or before July 1,

as to the status of your reservations, and the amount due.

The deadline for receiving payment is Saturday, July 14, 2018.

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