Please print and return this form by Tuesday, May 20, 2008

CAP TOURMENTE NATIONAL WILDLIFE AREA, QUEBEC   2008

Name(s): ___________________________________    

Tel.:    ___________________________________

Address: ___________________________________

         ___________________________________

         ___________________________________

Number of persons:         Members ______ x  $50    Enclosed $ ________

Non–members ______ x  $55     Enclosed $________


Hold Harmless Clause:

I, the undersigned, hold the Zoological Society of Montreal harmless from responsibility to life, limb, or property resulting from any accident, regardless of whatever may be the cause, on the above advertised event.

Signature: ___________________________________

Date: ___________________________________


I enclose a cheque for $________, payable to the Zoological Society of Montreal.

Mail to:
Zoological Society of Montreal,
1117 Ste-Catherine Street West, Suite 525
Montreal, QC
H3B 1H9

Tel.: (514) 845–8317


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