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RELATIONSHIP TO CHILD
BABY'S NAME BOY OGIRLQ DATE OF BIRTH_/__/__

FIRST AND LAST NAMES OF PARENTS

CHEQUEQ VISAQ MASTERCARDQ CARD# EXPIRY DATE _

SIGNATURE__ —_———

Mockonsi Deadline- Monday Jan. 14, 1998 Dalton Elson

Themaan
Photes will be returned by mail. as

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The North Shore News, 1997 Baby Album
1139 Lonsdale Ave., V7L 2H4

986-6222 or Fax 985-3227

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