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Please make sure all information you enter is legible - print clearly, use a black pen.
Name (individual or group):___________________________________
Street Address:_______________________________ ______________
City:____________________________ State: _________ Zip: _______
Phone: Home:________________ Work: ________________
E-mail Address: ____________________________________________
Registration (circle one): Individual Group Family
Pagan Name: _______________________ _______________________
Real Name (optional):_________________________ Age:__________
Volunteer Duty (*)__________________________________________
(*)A minimum of 2 hrs of work is expected for volunteer duty. Please list your prefe rence (time of day/type of duty).
Will you be attending the Wiccan University on Friday? _____________
If yes, there is a $5 fee. Please make sure to add this to your total amount.
Carpooling (Circle o ne): Yes No
Carpooling discount: Subract $1 from your amount due.
Number of: Cars ________ Tents __________
***NO RV's or campers allowed!***
Merchanting. There is no fee for merchanting. You will need to provide y our own set up. Tables may be available for a small fee. Do you wish to sell any items? _______ What would you be interested in selling? Please specify the items.___________________________________
Medical Information (Whether any of the participants listed above has a medical condition, allergies to bee stings etc.): __________________________________________________________
General Admission: Individual $17/Co uples $25 _$____________
NW Members Individual $12.50/Couples $20 _$____________
Wiccan University: ($5 each attendee) _$____________
Discounts*: - $_______ _____
*Carpooling: $1 dicsount. Discounts for group registration: 5th person in a group saves $2.50 and the 10th person in a group saves $5.00.
Limited number of scholarships available, ask Wren or Grey Cat when you send in your registrati on form.
Make all checks/money orders payable to "NorthWind".
You will receive an information package with entry pass(es) upon receipt of this registration form.