Javascript is required to use the online registration.

Please fill out the form below for pre-registration. Required Fields (*) must be filled in for all attendees.

Notes:

1. Make sure you have everything you want filled out before clicking on the Buy Now Button under the Checkout Tab! If you use your browser's back arrow from the PayPal page, you will lose everything in the forms you filled out.
2. You do not need to have a PayPal account to use this! It will also take Visa, Mastercard, American Express, and Discover credit cards.
3. Don't be disturbed that the item number in Paypal says April 10. I haven't figured out how to change that in Paypal yet, but by the fact you're using this form, I'll know it's for 2012.

Attendee 1

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Dealer Info

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Registration Type:*

Full Weekend Membership ($35) Student Full Weekend Membership ($25) Youth (ages 6-12) Full Weekend Membership ($15) Child (ages 0-5) Full Weekend Membership ($0) Day Pass ($20)

Day:*

Friday, April 20th Saturday, April 21st Sunday, April 22nd

 

Attendee is a dealer. Check this to see the Dealer Info tab for purchasing tables. You must get an OK from our Huxter Wrangler first before purchasing any tables!

 

Remove Attendee

Students will need to show a Student ID at the door to receive the discounted rate.

Name

 

First:*

Middle:

Last:*

Badge

 

Badge names are customizable, but limited to 40 characters per line for space reasons. The longer your badge name over 11 characters per line, the smaller it will appear on the badge. Editing your name above will reset these fields to First and Last Name.

Line 1:

Line 2:

Contact

 

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  Attendee 1

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Street:*

 

City:*

State:*

Zip:*

Email:

Phone:

Responsible Adult Contact

 

Attendee is 18 or over.

Attendees 12 and under must have a responsible adult attending the con.

Responsible Adult Is Attending:

  Attendee 1

First:*

Middle:

Last:*

 

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Street:*

 

City:*

State:*

Zip:*

Email:

Phone:*

Shirts

 

If you pre-order a shirt here, it will be reserved for you to pick up at the con. You can also buy shirts on-site at the con.

Color	M $10.00	L $10.00	XL $12.00	XXL $12.00	XXXL $12.00
Color
Grey

Name:*

Tables (6'x30"):*

1 ($30) 2 ($60) 3 ($90)

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Street:

 

City:

State:

Zip:

Email:

Phone:

Special Instructions:

Name	Item	Cost
	Total: