Each level will receive a social membership. The 4th and 5th level are the same amount but sponsor gets to choose what he/she wants

1st level $100.00 Social Membership
2nd level $150.00 Hat/Tshirt
3rd level $250.00 Golf Shirt
4th level $350.00 Golf Shirt/2 tickets to Dinner/Dance
5th level $350.00 Wasps Jacket

R. St. Germain
Winnipeg Wasps Rugby Club
257 Wales Avenue
Winnipeg, Manitoba
R2M 2S8


Please complete the following information and submit. Send your cheque for the appropriate amount made out to the WASPS RUGBY CLUB and mail to the above address.

Name:


Address:


City:


Province/State:


Postal Code/Zip Code:


Country:


Phone: (include area code if out-of-town)


Email:


Choose your level of support


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