Mail in Adoption Form
Lake Murray Kiwanis 2nd Great Duck Race
September 15th at Lake Murray, San Diego ~
Sponsored By Drew Ford La Mesa; RCP; Macy’s; Dixieline; Frazee Paints; & Many Others

The Lake Murray Kiwanis Club has Duck Adoption papers for the
2nd Great Duck Race at Lake Murray Street Fair on September 15 th, 2007
Plan to adopt our ducks and have them race to win one or more of these great prizes!

To Adopt A Duck, Please Print Form fill out the Form below
Mail the form with your donation enclosed to
Lake Murray Kiwanis Foundation,
P.O. Box 19283, San Diego, CA. 92158-0283

For more information call 619-449-DUCK, 619-449-3825 or visit www.lakemurraykiwanis.org

Prizes for the Event
New ~ 2007 Ford Ranger, Drew Ford La Mesa
Mission beach Vacation Condo One Week (based on availability sleeps 4-6 people)
Cuyamacha Lake Water Front One Week Stay & Boat Rental ( day of choice)
$500.00 “Shopping Spree” Macy’s
$500.00 “Gift Card” Dixieline Lumber
$300.00 “Gift Certificate” at Frazee Paint
And Many More

Donor Information Adopt-A-Duck Thank you for your generous donation.

Group _______________________________ Key #; K05399
     

Name

First___________________________

Last____________________________

Address

_______________________________

________________________________

City

_______________________________

State______

ZIP Code__________

Phone #

(____) ___-_________

Phone (business)(____) ___-________

Fax #

(____) ___-_________

E-Mail__________________________

  _  

Adoption Information
Please make checks, corporate matches, or other gifts payable to:
Lake Murray Kiwanis Foundation
P.O. Box 19283, San Diego, CA 92159-2083

Adopt ~A ~ Duck to Win~ A ~Truck

Duck Packs  

Single Ducks (1 Duck)

______

Single 1 Duck @ $5 each

$ _____

Big Quacks ( 5 Ducks

______

Big Quacks 5 Ducks @ $25 each pack

$ _____

Quackers Pack (10)

______

Quackers 10 Pack-10 Ducks @ $50 each pack

$ _____

Flock of Ducks (20)

______

Flock of Ducks - 20 Ducks @ $100 each flock

$ _____

Super Flock (50) ______ Super Flock - 50 Ducks @ $250 each Super flock $ _____

Total # of Ducks

______

Total Amount Paid

$ _____

   

I would like to pay by

______Cash _______Check to LMK Foundation ______ Credit Card ______

Credit card type

______ Visa _______Master Card ______ American Express

Credit card number

______________________________________

Expiration date__________

Print Name

________________________________________________

Authorized Signature

________________________________________________

Sponsoring Organization

________________________________________________


K05399

Thank you for your support