National Parents' Day Award Banquet

6:30pm, Friday, July 30, 2010
Manhattan Center Hammerstein Ballroom
311 West 34th Street, New York, NY 10001

REGISTRATION FORM

* Required fields

First Name*: Last Name: * Address: * Phone Number: * E-Mail: *

Tickets *	Price	Qty.
Adult	$40.00
Couple	$70.00
Young Adult (age 18-35)	Free
Young Couple (age 18-35)	Free

* 9th - 12th graders and infants are free and will have their own seating area. To reserve space for your hight school student and/or infant, check below:
Number of High School Students: Number of infants:

Payment Method: * Check/Money Order Cash Paypal

Check/Money Order: Make a check/money order payable to "UPF USA" and mail to: UPF USA, 481 8th Ave. Suite 607, New York, NY 10001 or bring it to the registration table at the event place.
Cash: Bring it to the registration table at the event place.