Combined registration form

Instructions:

Please print this form. If possible, submit one form per person. Please pay in Canadian $ if possible. (If not convenient, amounts in U.S. $ are also shown.) Cheques should be made payable to Kyah Wiget Education Society. Mail completed registration forms to:

Kyah Wiget Education Society
RR 1, Site 15, Box 25
Moricetown BC V0J 2N0
Canada

Questions? Call KWES (250) 847-5345, or Sharon Hargus, (206) 685-4263.

Registration should be received by:

• May 16 if you would like to be considered for billeting in Moricetown,
• or by May 26 if you would like to receive a discount on registration fees.

Registration form

Name ________________________________________________________________

Address_______________________________________________________________

_____________________________________________________________________

Phone_____________________________FAX _______________________________

E-mail________________________________________________________________

Do you have a disability?_________________________________________________

Do you have a special diet?_______________________________________________

Registration fees. We are offering a discount for early registration (payment received by May 26).

I wish to register for the Workshop _____, Conference _____, both Workshop and Conference _____.

Total registration enclosed: ________________________________________________.

Please note: this is a break-even event, not a money-making event for anyone. Your registration fees simply pay the cost of bus transportation to/from Smithers; lunch; photo-copying and mailing; assorted other expenses.

Extras.

I would like to reserve a craft table at the Conference: $10/table x _____ days = _________________

I would like to reserve day care: ____ child(ren) x ____ days x $10/child = _______

Ages of children: ______________________________.

Total for extras: _________________________________________________________.

Accommodation:

We anticipate that most Workshop and Conference attendees will make private arrangements to stay in a motel or Bed and Breakfast in Smithers, about 34 km. (21 miles) south of Moricetown. However, a small amount of billeting in private homes in Moricetown may be possible (especially for Conference participants). Please return this form by May 16 if you would like to be considered for billeting. If you are interested in billeting, please explain why it would be particularly advantageous to you.

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

Are you interested in camping at Moricetown campground? It will either cost $15/night or be free of charge to Workshop and Conference attendees. _____________________

If you are staying in Smithers, will you need a ride to Moricetown for the conference?_______

Alternatively, can you supply a ride to Moricetown?_______

Please indicate number of people and days you need a ride or can supply one:

__________________________________________________________________