Official Rosebud Entry Form
Name: ______________________________________________________________
Address: ______________________________________________________________
City: _________________State: ____________Zip: _______________
Phone: _____________________________Cell:____________________________
Email: ______________________________________________________________
Date of Birth: _____________________________________
(Must be 5-12 years old)
Father’s Name: _________________________________________________________
Mother’s Name: _________________________________________________________
Sisters and Brothers:
Name: __________________ Age: ______ Name: _________________ Age: _______
Name: __________________ Age: ______ Name: _________________ Age: _______
Name: __________________ Age: ______ Name: _________________ Age: _______
School Name: _________________________________________________________
Irish surnames in your family: _____________________________________________________________
_____________________________________________________________
Signature of parent or guardian:
_____________________________________________
Date: ________________________________________________________________
Return completed form along with the $100 Rosebud entry fee made payable to Lovely Events Inc. by March 21, 2012.
For more information please contact:
Mary Kay Gavin-Marmo & Deirdre McNulty Kochuparambil
11137 S. Artesian
Chicago, Illinois 60655
773-239-3927
