Register for Heart of Technology's Bette Ruch-Rose End-of-Summer Cookout at Calero

First name:

Last name:

Email:

Will you attend:

Please help us plan for food and beverage by indicating if you will attend and, if so, the number of people in your group

Yes	# Adults:	# Kids:
Maybe	# Adults:	# Kids:
No, but please add me to your mailing list

Do you have
any special needs: