CENTENNIAL ACTIVITY REGISTRATION FORM
ENTRY FORM

Name:____________________________________________________________________

Address:__________________________________________________________________

Phone:____________________________________________________________________

E-Mail:___________________________________________________________________

I am registering for (circle those that apply):
  • Bocce  ($5 each or $10 per team)
  • Horseshoes ($5 each)
  • Car Show  $15
  • Motorcycle Show  $5
  • Dance Contest: ($10 per couple per category)
 (Circle your entry choice:  Charleston, Swing, Rock 'n Roll, Tango, Waltz, Twist, Disco, Polka, Country/Western, Salsa, Current Dance (to be announced))

Car Show Info:  Car Year:______________

Make/Model:______________________________________________________

Car Club (if applicable) :_____________________________________________________

Motorcylce Show Info:  Year:______________

Make/Model:______________________________________________________

Club (if applicable) :_____________________________________________________


Send entry form along with check made payable to FCCI to:

Franklin Community Council, Inc. P. O. Box 43, Franklin, Ks. 66735  Attn: Centennial

All events will take place in downtown
 Franklin, Kansas (69 business highway)

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 Centennial
 E-mail: memrylane@yahoo.com