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To register online, fill out the form below and click on the Submit button. Or if you prefer to use regular mail, print out the form and mail it in. Click here to print out a copy of the form, then mail your completed form to:

Dean Petruk
#43-16655-64th Avenue,
Surrey, B.C.
Canada
V3S 3V1

Petruk Family Reunion Registry Adult $32 (12 years and above) Child $25 (6-11 years)
One form per household
First Name(s)

Last Name
T-Shirt Size
Address

City
Province
Postal Code
Country
Email
Phone (include area code)
Fax (include area code)
Family Members
Name and Birthdate
T-Shirt size
T-Shirt size
T-Shirt size
T-Shirt size
Total number of family members attending Total Adults Total Children
Do you require a trailer hook-up site? Yes No
Do you require a camp site? Yes No
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