Christmas Magic
  presented by Family House

  Please return by 11/21/05

_____ Children $15.00 each                 _____ Little Elf    ______ Big Elf

_____ Adults $20.00 each                    ____ Vegetarian Plate Requested

              _____ High Chair(s)                  _____ Booster Seat(s)

Cannot attend, but wish to make a donation $ _______________
                 (make checks payable to Family House, Inc.

Name __________________________________________

Address ________________________________________

City ___________________  State _____  Zip __________

Credit Card ________________________  Exp. Date _____

Signature ______________________________

Mail to:  Family House, 1509 N. Knoxville Ave., Peoria, IL 61603
                         Telephone: 309-685-5300