Trixie Camp 2009

REGISTRATION FORM

Name:      

Address:   

City:           

State:     Zip/Postal Code: 

Phone: 

Message Board ID:         

E-mail address: 

Room preference:  Double occupancy    Single occupancy

List any particular preferences regarding roommates: 

List any special food requirements: 

Shirt size: 

Under age 18?  Yes    No

If you are attending with a family member, please have each individual fill out a separate registration form.