COLLINS BOWLING BIRTHDAY CLUB
Collins Bowling Centers, Inc.
2 Locations
SOUTHLAND EASTLAND
205 Southland Drive 750 East New Circle Road
Lexington, KY 40503 Lexington, KY 40505
859-277-5746 859-252-3429
Member Information
Complete the form below to be enrolled into the birthday club.
*
First Name
*
Last Name
*
Email Address
*
Male or Female?
Male
Female
*
Birthday Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
*
Day of Month
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
*
Birthday Year
1960 or below
1961-1970
1971-1980
1981-1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
*
Address 1
*
City
*
State
*
Postal Code
*
Phone
*
Where did you hear about Collins Bowling Centers, Inc.?
Email advertisement
Flyer or posting
Friend or family
Chevy Chaser / Southsider Magazine
Personal Inquiry
Google Search
Yahoo Search
Cable TV
1380AM Real Life Radio
Radio Other
Other
*
Contact me via phone with club information and announcements.
Yes
No
*
Contact me via email with club information and announcements.
Yes
No
Terms and conditions:
Birthday club members are eligible to win a birthday party package for up to 12 people inlcuding shoe rental and 2 hours of bowling. Members will also be eligible to receive discounts and a free game of bowling during the month of their birthday. Collins Bowling Centers does not give out the names and emails of any members of the birthday club to any outside agencies or companies.
*
I have read and agree to the terms and conditions.
Yes
No
*
Indicates Response Required
This form created at
http://www.formsite.com/