Mothers' Club Fashion Show
Online Registration and Payment Form

Reservation Contact

First Name*

Last Name*

Affiliation to La Salle*

Current Parent Past Parent Friend of La Salle

Son(s) Class Year(s)*

If more than one, separate by commas

Preferred Phone Number*

Attendees

Number of Reservations*

$60 per person

Attendee 1 First Name*

Attendee 1 Last Name*

Attendee 1 Meal*

Chicken Alexandra (chicken dipped in egg, mushrooms, asparagus tips, red peppers, in a lemon butter sauce) Gluten Free Chicken Alexandra Vegetable Wellington (grilled vegetables baked in a puff pastry served on a sweet red pepper sauce)

Attendee 2 First Name*

Attendee 2 Last Name*

Attendee 2 Meal*

Chicken Alexandra (chicken dipped in egg, mushrooms, asparagus tips, red peppers, in a lemon butter sauce) Gluten Free Chicken Alexandra Vegetable Wellington (grilled vegetables baked in a puff pastry served on a sweet red pepper sauce)

Attendee 3 First Name*

Attendee 3 Last Name*

Attendee 3 Meal*

Chicken Alexandra (chicken dipped in egg, mushrooms, asparagus tips, red peppers, in a lemon butter sauce) Gluten Free Chicken Alexandra Vegetable Wellington (grilled vegetables baked in a puff pastry served on a sweet red pepper sauce)

Attendee 4 First Name*

Attendee 4 Last Name*

Attendee 4 Meal*

Chicken Alexandra (chicken dipped in egg, mushrooms, asparagus tips, red peppers, in a lemon butter sauce) Gluten Free Chicken Alexandra Vegetable Wellington (grilled vegetables baked in a puff pastry served on a sweet red pepper sauce)

Attendee 5 First Name*

Attendee 5 Last Name*

Attendee 5 Meal*

Chicken Alexandra (chicken dipped in egg, mushrooms, asparagus tips, red peppers, in a lemon butter sauce) Gluten Free Chicken Alexandra Vegetable Wellington (grilled vegetables baked in a puff pastry served on a sweet red pepper sauce)

Attendee 6 First Name*

Attendee 6 Last Name*

Attendee 6 Meal*

Chicken Alexandra (chicken dipped in egg, mushrooms, asparagus tips, red peppers, in a lemon butter sauce) Gluten Free Chicken Alexandra Vegetable Wellington (grilled vegetables baked in a puff pastry served on a sweet red pepper sauce)

Attendee 7 First Name*

Attendee 7 Last Name*

Attendee 7 Meal*

Chicken Alexandra (chicken dipped in egg, mushrooms, asparagus tips, red peppers, in a lemon butter sauce) Gluten Free Chicken Alexandra Vegetable Wellington (grilled vegetables baked in a puff pastry served on a sweet red pepper sauce)

Attendee 8 First Name*

Attendee 8 Last Name*

Attendee 8 Meal*

Chicken Alexandra (chicken dipped in egg, mushrooms, asparagus tips, red peppers, in a lemon butter sauce) Gluten Free Chicken Alexandra Vegetable Wellington (grilled vegetables baked in a puff pastry served on a sweet red pepper sauce)

Attendee 9 First Name*

Attendee 9 Last Name*

Attendee 9 Meal*

Chicken Alexandra (chicken dipped in egg, mushrooms, asparagus tips, red peppers, in a lemon butter sauce) Gluten Free Chicken Alexandra Vegetable Wellington (grilled vegetables baked in a puff pastry served on a sweet red pepper sauce)

Attendee 10 First Name*

Attendee 10 Last Name*

Attendee 10 Meal*

Chicken Alexandra (chicken dipped in egg, mushrooms, asparagus tips, red peppers, in a lemon butter sauce) Gluten Free Chicken Alexandra Vegetable Wellington (grilled vegetables baked in a puff pastry served on a sweet red pepper sauce)

Attendee 11 First Name*

Attendee 11 Last Name*

Attendee 11 Meal*

Chicken Alexandra (chicken dipped in egg, mushrooms, asparagus tips, red peppers, in a lemon butter sauce) Gluten Free Chicken Alexandra Vegetable Wellington (grilled vegetables baked in a puff pastry served on a sweet red pepper sauce)

Attendee 12 First Name*

Attendee 12 Last Name*

Attendee 12 Meal*

Chicken Alexandra (chicken dipped in egg, mushrooms, asparagus tips, red peppers, in a lemon butter sauce) Gluten Free Chicken Alexandra Vegetable Wellington (grilled vegetables baked in a puff pastry served on a sweet red pepper sauce)

Seating Preference

I/we would like to sit with:

Tombola Tickets

Past Presidents' Gift Tickets

An Exquisite Piece of Designer Jewelry or High Tea for Four at the Four Seasons

$5 for 1 ticket $20 for 5 tickets $35 for 10 tickets

Luxury Tombola Tickets

$5 for 1 ticket $20 for 5 tickets $35 for 10 tickets

$500 Cash Tickets

$5 for 1 ticket $20 for 5 tickets $35 for 10 tickets

Tombola Tickets

$3 for 1 ticket $10 for 4 tickets $20 for 10 tickets

Total Amount of Registration and/or Tombola

Please send a confirmation email to the address below*: