2025 - Annual Meeting Registration Form

2025 Annual Meeting Registration Form

New England 65 Plus Runners Club
Instructions:

Use this form to purchase your Annual Meeting Brunch tickets and pay online using your credit card. You will be asked for credit card information before you can submit the form.

If you do not want to use your credit card on line, do not use this form, but instead download this paper form by clicking here.

Note: If you are 90 years old or older your meal is FREE and you do not need to enter credit card information. Just fill out this form and click "Submit.

Questions? Email David Theoharides - webadmin@ne65plus.org
Annual Meeting and Brunch
Monday, October 27, 2025
10:00 am to 2:00 pm

Atkinson Country Club
85 Country Club Drive, Atkinson, NH

Cost $40 / person (under 90 years old)

FREE for members 90 years old plus!

Please complete registration form below and
click submit button when done.
You will receive a confirmation email of registration and payment.

Registration Deadline 10/13/2025
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Are you or any of your guests 90 years old or over?*

YesNo
# of FREE Buffet Tickets for you or guests 90 years old or older
Enter # of FREE 90 year+ Tickets Needed
Are you bringing any guests?*

YesNo
How many additional guests?
Type # of ADDITIONAL Guests
List any dietary restrictions
List additional Guest(s) Name(s) below:
Write names of additional guests
Purchase Buffet Brunch Tickets

$40 per person UNDER 90 years Old
Check box below and enter total # of tickets purchasing @$40 each then fill-in credit card information.
prevnext( X )
# Buffet Tickets for UNDER age 90 years oldCHECK BOX and enter # of tickets you will purchase below
$40.00 # of Tickets for UNDER 90 years old

Total

$0.00

Pay with Credit Card

Should be Empty:

2025 Annual Meeting Registration Form

Purchase Buffet Brunch Tickets