Pierce County Parks Fantasy Lights Preregistration Form

Pre-registration must be received by November 16, 2011
Name:
Address:

City:	Zip:
Phone:	E-mail:


Total Number of Walkers	#
Total Enclosed:	$

MasterCard/Visa Card Number:

___________________________________________ Exp. Date_________

Cardholder's Signature__________________________________________

Mail completed registration form with payment payable to:

Pierce County Parks & Recreation
Fantasy Lights Walk
9112 Lakewood Drive SW
Lakewood, WA 98499

Acceptable forms of payment are Visa/MasterCard, checks or money order.

No confimation will be sent.
No refunds will be given due to inclement weather.

Pierce County Parks & Recreation
9112 Lakewood Dr. SW, Lakewood, WA 98499