2009 ADOPT A BOOM!!

ADOPTION APPLICATION

NAME_____________________________________

 ADDRESS__________________________________

 TELEPHONE NUMBER_______________________

 I WOULD LIKE TO ADOPT A BOOM FOR THE UPCOMING ÒMEDICINE PARK/ LAKE LAWTONKA FIREWORKS DISPLAYÓ.

SIZE OF BOOM

PRICE OF BOOM

# OF BOOMS

TOTAL

3 INCH

$ 7.00

   

4 INCH

$ 15.00

   

5 INCH

$ 24.00

   

6 INCH

$ 46.00

   

8 INCH

$ 78.00

   

10 INCH

$ 189.50

   

12 INCH

$ 336.00

   

OTHER ITEMS

$ DonorÕs Choice

   
TOTAL ADOPTION DONATION:Ê
Ê$

PLEASE MAIL THIS ADOPTION FORM AND YOUR DONATION TO:

Medicine Park Fire Department
Adopt a Boom
P.O. Box
Medicine Park, OK 73557

ANY AND ALL DONATIONS ARE GRATEFULLY ACCEPTED, AND WILL HELP US CREAT A BETTER SHOW FOR YOU TO ENJOY!

 CONTACT INFO:  Corey Freeman (682)-429-7383