Norwescon 29 Pre-Registration
PO Box 68547
Seattle, WA 98168-0547
Please, fill out a separate form for each person age 13 and over attending the convention. Members will be asked for photo identification and signature when checking in.
Suggestion - Make a copy of this form and a copy of your method of payment (check, money
order, cash receipt), save it, and take it with you to the convention. Just to be safe. Please print clearly, thank you.
Persons under the age of 18 MUST have a completed
permission form in order to attend the convention.
Name_____________________________________________________________________________________
Badge Name_______________________________________________________Birthdate_____/_____/______
Address___________________________________________________________________________________
City______________________________________ State/Prov_____________ Zip/PC__________________
Phone(_________)___________________________ Email________________________________________
__ I have moved since I last attended Norwescon (please list your prior address & phone # on the back of this form)
Names of children 12 years and younger (Admitted free with a paying adult member); please include each child’s date of birth. Please fill out a permission form for each child under the age of 13.
________________________________________________________________Birthdate_____/_____/_______
________________________________________________________________Birthdate_____/_____/_______
From time to time, Norwescon prints the names of our members in our
publications. If you wish your name to be omitted, check here. ____
If you wish to receive Norwescon publications by email, check here.
____
I agree to abide by the rules and policies of Norwescon.
Signature______________________________________________________________Date__________
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$55 (U.S.) until March 15, 2006. There is a $5 (U.S.) discount for NWSFS members. Enter the Membership and deductions you are entitled to and total. _____ 1 @ $55.00 (attending membership) _____ -$5.00
NWSFS discount (*Please include your NWSFS member #____________)
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| Total enclosed: $ ________ | Check
/ Money Order #___________________ ( make payable to Norwescon) |