Yes! We would like to sign up for
LUV-A-THON 2010
Date: Saturday, 20th March 2010, 1.30 pm -7.30 pm
Venue: The Singapore Flyer, Sky Deck

*Required field  
Name of Participant*: Name of Spouse*:
Age*: Age*:

Contact No. :

(m*) (h) (o)
Postal Address*:
E-mail*:

Marital Status:
Engaged, No. of Months Engaged
Married, No. of Years Married

 
Payment by* : Cheque Cash

All Cash payment should be made personally to:
Whispering Hearts Family Service Centre
Blk 646 Jurong West St 61 #01-142 Singapore 640646 during office hours (Mon, Wed & Fri 9 am - 6 pm, Tue & Thur 9 am - 9 pm, Sat 9 am - 1pm)

Closing date: 18th March 2010

All cheques should be crossed and made payable to :
Whispering Hearts Family Service Centre
And send to the above mentioned address.

Cheque Number:

Amount:

Note:
Confirmation of registration only upon receipt and clearance of payment. A detailed programme and other administrative information will be sent to you upon confirmation of registration.

Cancellation Policy:
In the event of any withdrawal of participation, the payment will not be refunded.