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Pumpkin Registration
To register a decorated pumpkin at
Jack-O-Lanterns on 5th
Please fill out the following form
and click "submit".
Scroll down or
Click
HERE to access registration form.
OR
Bring your decorated pumpkin to the Fifth Street
Public Market on Saturday, October 24, and register it
at Pumpkin Central
(The Fifth Street Public Market's south parking lot).
JACK-O-LANTERNS ON 5TH
A festival of monstrous proportions
Saturday, October 24, 2009
To register a pumpkin at Jack-O-Lanterns on 5th, please fill out
the following form and click "submit" OR be sure to submit
your pumpkin on the day of the event with one of our officials.
Name of sponsoring business,
group, or individual
Address
State
City
Zip
Phone
Email
Number of pumpkins you plan on bringing
ShelterCare is asking a $2.00 registration fee for each pumpkin registered.  
This contribution will help in our fight against homelessness.
Pay now or pay at the event when you arrive with your pumpkin!
To pay via credit card, fill out the fields below. This secure form will be emailed to
ShelterCare where your card will be processed and a receipt of the transaction
will be generated and returned to you.  You may also contact Lucy Vinis at
ShelterCare by calling (541) 686-1262 with all relevant information ready.
Card Type :
Expiration Date :
16 digit Card Number :
To pay via check, cash, or money order, please print and mail this completed form to the following address :
ShelterCare
PO Box 23338
Eugene, OR 97402