Leo Registration Form 

Leo Program Agenda

            60^th ANNUAL MD 23 LIONS MID-WINTER CONFERENCE

CONNECTICUT LEOS MID-WINTER PROGRAM

Saturday, February 5, 2011

Connecticut Leo/Leo Advisor Registration Form

THE HOLIDAY INN, 3580 East Main Street, Waterbury, Connecticut

INTERNATIONAL GUEST: International Director Gary Anderson 

First Name preference on badge (please print):  __________________________________________

              Schedule of Events (Speakers and Program Content to be Announced):

Leo Registration                                             8:45 a.m.    ~     9:30 a.m.

Leo Program and General Meeting                9:30 a.m.    ~   12:00 noon

Leo Lunch                                                      12:00 noon   ~  12:30 p.m.

Leo Program                                                  12:30 p.m.    ~    1:00 p.m.

Water Resort (or Program)                              1:00 p.m.    ~     3:00 p.m.

             REGISTRATION:  Fee Includes Registration and a Box Lunch                $15.00                   _______

     Please note any dietary restrictions: ___________________________________

CoCo KEY WATER PARK (2 hours from 1:00 p.m. to 3:00 p.m.)                              $15.00                  _______

TOTAL ENCLOSED                                                                                                                           $_______

Complete this registration form for each Leo/Advisor attending and send forms and checks payable to the "2011 MD23 Mid-Winter Conference" to Lion Diana Grisé.

Registration Deadline:  Please be sure to return your registration form and payment no later than January 21, 2011.  ABSOLUTELY NO REGISTRATIONS WILL BE ACCEPTED AFTER THIS DATE WITH NO EXCEPTIONS.