2004 Sporting Luncheon Order Form

25 July 2004

2004 Sporting Luncheon Order Form 2004 BLUE MOUNTAINS RUGBY SPORTING LUNCHEON ORDER FORM Name I wish to order 1._________ Tickets @ $100.00 per Head or 2._________ Table of 10 @ $900.00 Payment by: Cheque- Make payable to Blue Mountains District Rugby Football Club Credit Card (Please fill in details below) Please Tick one) Bankcard Mastercard Visa Credit Card No: Expiry Date: Cardholder Details: Signature Name Address: Phone No Forward Payment to The Secretary Blue Mountains Rugby Po Box 314 Blaxland 2774
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