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Surname and Name *

Prénom

Nom

Member number (if known)

Address Line 1: no, street, City *

Address Line 2: province, country, postal code

E-Mail *

Number of persons : ? adults et ? children (12 yrs and less

Indicate the number of adults and children

Names of persons who will accompany you

Registration for adults and Dinner options *

1. Price per adult 95$: Includes registration, conference, Guided visit of historic La Prairie, cold lunch buffet and Hot Buffet Dinner (choose salmon or porc below) + Free Demers Family Place Mat
2A. Salmon Fillet
2B. Porc belly
Food allergies: Please click here and specify allergies in the Comments section below

Calculate the total in the next box to know the amount of your payment.

Total payment and my choices for Dinner *

Please provide the following information in the Box above
# of adults X 95$= Total $

Dinner option selection
# of 2A salmon =
# of 2B pork belly =

PLEASE ALSO SEE OUR SPECIAL OFFER OF DEMERS FAMILY PROMOTIONAL PRODUCTS ON THE BOUTIQUE PAGE OF THE WEB SITE. Pick up at the Annual Gathering.

I will make payment by *

Interac transfer to gingrasluc2@hotmail.com (Question: Date of foundation? Answer: 001990)
Cheque to Association des familles Demers Inc.

Comments or Questions