Registration Form

 
2010 WSSCAR State Conference Registration Form

Registration Deadline by February 15, 2010 – First 20 kids who register get a free WSSCAR Tote bag!

 

Yes, I/we plan to attend:

  o      Fort Vancouver:

                        Family (Any # for $5): ______ Individual Members ($3): _______               Total: $______.

  o      Pizza lunch (donated by Anderson’s Fabrication) – Please indicate # of slices of each flavor

                        Pepperoni  _______    Cheese: ______        Vegetarian: ______

  o      Conference at Library:            # Adults: ______   # Society members: _______

  o      Firstenburg Community Center (Wave Pool):

                                    Child to 18 ($3.75) x: ______                         =  $________

                                    Adult: >18 ($5.75) x: ______                          =  $________

                                                                                    Subtotal:         =  $________                    $______

                                                                                                                                                Total: $_______

Parent name: ________________________________________      Email: _____________________________

Address:       _________________________________________  Phone(1)___________________________

                    _________________________________________  Phone: (2)__________________________

Child(rens) Name: ____________________________________  Society Name________________________

     Name: ____________________________________  Society Name________________________

                                                    (continue on back or additional page if necessary)

Please mail checks payable to: WSSCAR: to  Peggy Goldenman, 7075 SE Kansas, Port Orchard, WA  98366-7172

     Questions:  Conf@WastateCAR.org
  
 

 
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This page was last updated January 13, 2010