Name                                                                  Select        Meal Choices

1.     Pick Dish London Broil Smoked Salmon Stuffed Chicken Child Beef    Fish   Chicken   Child  (up to age 12)

2.     Pick Dish London Broil Smoked Salmon Stuffed Chicken Child Beef    Fish   Chicken   Child  (up to age 12)

3.     Pick Dish London Broil Smoked Salmon Stuffed Chicken Child Beef    Fish   Chicken   Child  (up to age 12)

4.     Pick Dish London Broil Smoked Salmon Stuffed Chicken Child Beef    Fish   Chicken   Child  (up to age 12)

5.     Pick Dish London Broil Smoked Salmon Stuffed Chicken Child Beef    Fish   Chicken   Child  (up to age 12)

6.    Pick Dish London Broil Smoked Salmon Stuffed Chicken Child Beef    Fish   Chicken   Child  (up to age 12)

7:    Pick Dish London Broil Smoked Salmon Stuffed Chicken Child Beef    Fish   Chicken   Child  (up to age 12)

8.    Pick Dish London Broil Smoked Salmon Stuffed Chicken Child Beef    Fish   Chicken   Child  (up to age 12)

 Total # of tickets.@ $50.00 ea.

Children # of Meals@ $20.00 ea.

 Amount Enclosed: $

After confirmation email is received, please mail check to:

Celtic Thunder Youth Pipe-Band

c/o Emerald Ball

170 Main Street

Monson, MA  01057

If you have a problem submitting this form, please e-mail Pipemajor@charter.net

Thank You