Berry Field Day Registration Form

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WISCONSIN BERRY GROWERS ASSOCIATION
Summer Field Day

Friday, May 14, 2010 - Govin's Meats & Berries,

N6134 670th St, Menomonie, WI 54751
Registration at 8:30am, Program begins at 9:00am and adjourns by 3:00pm

Registration:
Farm Name

Attendees Name(s)

Address

City State Zip

Phone Email

Registration Fee (includes lunch)
_____ WBGA Member Farm ........$23.00/person

_____ MN Fruit & Veg Assn Members........$30.00/Person

_____ Non-member Farm............. $38.00/person

Registration after 5/1/2010, add $10.00 Late Fee.

Total Due $

Please remit fees to: WBGA, 211 Canal Road, Waterloo, WI 53594
Phone: (920) 478-3852 * Fax: (920) 478-9586

Driving Directions:

If you wish, you can charge to your MASTERCARD VISA

Name of Card:

Card Number:

Expiration: / Signature:

Directions: From I-94, take Exit 45 at Menomonie south on County Hwy B. Turn left on 610th Ave. 1.5 miles to farm. From Hwy 12/29, turn north on 670th Ave. east of Menomonie. Go 1.5 miles to the farm.

Note: GPS and mapping programs will give a false location. Use the map/directions above.