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Register for CIRCNA XIV: June 29 - July 1, 2012

Please fill out the order form below. Early Bird Registration ends February 1, 2012. Preregistration ends May 1, 2012.

CIRCNA XIV REGISTRATION
Qty.Price (ea.)Total
Preregistration
On or before May 1, 2012 (Save $10)
 $25.00 $0.00
Child Registration
Non-addicts under 18
 $5.00 $0.00
ENTERTAINMENT
Qty.Price (ea.)Total
Saturday Night Comedy Show
May not be appropriate for kids
 $15.00 $0.00
Friday Bingo - 10:00pm
 $10.00 $0.00
Friday Bingo - Midnight
 $10.00 $0.00
Saturday Bingo - Afternoon
 $10.00 $0.00
BANQUET
Saturday Night Main Banquet
   
Beef
 $45.00 $0.00
Chicken
 $45.00 $0.00
Vegetarian
 $45.00 $0.00
Reserve a Saturday Banquet Table for 10
Select a combination of 10 banquet dinners above
(Item will be removed from orders less than 10 banquet tickets)
 $0.00 $0.00
PREREGISTRATION MERCHANDISE
Orders must be placed by May 1, 2012
Qty.Price (ea.)Total
Large Duffel Bag - Tan
 $20.00 $0.00
Newcomer Donation
Qty.Price (ea.)Total
Newcomer Donation
SUB-TOTAL $0.00
TOTAL $0.00