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Baton Rouge Antique & Relic Show Registration Form
May 2, 2020
Name: ___________________________________________________________________________________
Address: _________________________________________________________________________________
City: __________________________________________ State: ________ Zip code: ___________________
Email Address: _______________________________________Phone:______________________________
Table Cost before April 18, 2020 Quantity Total $
$15.00 for 6' _______________ _______________
$20.00 for 8' _______________ _______________
Electricity is $5.00 extra per table. _______________
Total $ _______________
Table Cost after April 18, 2020 Quantity Total $
$20.00 for 6' _______________ _______________
$25.00 for 8' ______________ _______________
Electricity is $5.00 extra per table. _______________
Breakfast snack and coffee are included Total $ _______________
Possible $5.00 lunches as long as they last. How many? ________
Make Check Payable To: Friends of Port Hudson
Mail To: FOPH / Attn: Maryanne - 4288 Cooper Lane - Jackson, LA 70748
Contact Maryanne 9am - 5pm: 225 235-9355 ronldmac@gmail.com for dealer table assignment
CONTACT: John Potts for further details 8am-10pm- 225 937-2782
Email brcwrt@att.net Website www.brcwrt.com
May 2, 2020
Name: ___________________________________________________________________________________
Address: _________________________________________________________________________________
City: __________________________________________ State: ________ Zip code: ___________________
Email Address: _______________________________________Phone:______________________________
Table Cost before April 18, 2020 Quantity Total $
$15.00 for 6' _______________ _______________
$20.00 for 8' _______________ _______________
Electricity is $5.00 extra per table. _______________
Total $ _______________
Table Cost after April 18, 2020 Quantity Total $
$20.00 for 6' _______________ _______________
$25.00 for 8' ______________ _______________
Electricity is $5.00 extra per table. _______________
Breakfast snack and coffee are included Total $ _______________
Possible $5.00 lunches as long as they last. How many? ________
Make Check Payable To: Friends of Port Hudson
Mail To: FOPH / Attn: Maryanne - 4288 Cooper Lane - Jackson, LA 70748
Contact Maryanne 9am - 5pm: 225 235-9355 ronldmac@gmail.com for dealer table assignment
CONTACT: John Potts for further details 8am-10pm- 225 937-2782
Email brcwrt@att.net Website www.brcwrt.com