Registration Form Fall 2020

Use a SEPARATE FORM for each member

Name (last, first) ______________________________

Email _______________________________________

Check the box next to each item you are registering for. Add the fees and enter total on next page.
Check Box Forum, Event, Class, Trip, Club Fee
F1809, Holiday Pops: Songs of the Season
F1808, Lunatics, Lovers, and the Poetry of Shakespeare
F1901, Travel Adventure Road Scholar
F1902, A Trip Around Patagonia
F1903, French Impressionism
F1906, Bridge Club
F1907, Book Club
F1908, Lunch Club
. F1909, Mah Jongg Club
F1910, Hound Dog
F1905, The Lincoln Assassination Conspirator’s Trial
F1905, A or B Annual Holiday Luncheon, A. Member $15, F1905 B. Guest $25 $15/$25

Total balance due $__________

Enclose a check payable to LLI-Manassas for total balance due. You will not be registered unless membership dues and class fees are paid.Are you registering for a bus trip? If so, you must include the Acknowledgement, Release and Waiver form, along with Emergency Contact Information, (next page).
Mail all forms and check to:

LLI-Manassas

PO Box 284

Haymarket, VA 20168

 

 
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