To Order Your Tickets:  Print, Fill Out, and Fax to 801-423-9102

2006 DINNER EVENT TO BE ANNOUNCED...

CHAINBREAKER FOUNDATION and MRS. UTAH UNITED STATES JOIN WITH THE CHILDREN'S JUSTICE CENTER TO PRESENT

BANQUET BENEFIT FOR VICTIMS OF ABUSE

325 West Ash Woodland Hills, Utah 84653  801-423-0111 Fax 801-423-9102

PURCHASED BY: ____________________________________________________

ADDRESS: __________________________________________________________

CITY _________________________________ STATE _____ ZIP ______________

PHONE _______________________ E-MAIL ______________________________

NUMBER OF DINNER TICKETS ______________________ @ $75.00 EACH           $ __________

                Date to be Announced (Cocktail 6:30/Dinner 7:00 pm) *Best Dress Event TOTAL          $ __________

MAKE CHECKS PAYABLE TO: CHAINBREAKER FOUNDATION  a 501(c)(3) non-profit organization

Paid by Check Number ________________ Credit Card Visa/MC ________________________ exp. ___/____

_____________________________________________

Authorized Signature

YOUR OFFICAL DINNER TICKETS WILL BE MAILED TO YOU. 

ChainBreaker Foundation

BANQUET TICKET PURCHASES ARE NON-REFUNDABLE.  All proceeds will be used to further the education and recovery of victims of abuse and their families as deemed necessary by the Foundation.  The awards and prizes are drawn at random and cannot be controlled by the Foundation.  As a result, the Foundation cannot be found liable for the final outcome.  It is not necessary to be at the banquet to win or redeem a prize.  Winners, not present at dinner event, will be notified through the United States Postal Service.  Proper photo identification will be required in order to pick up or collect prizes.  Pick-up, freight, postage, or delivery fees are the sole responsibility of the individual awarded the prize.  Must be 18 years or older to participate.