|
Name:_____________________________
Badge Name (if different):_______________
Address: __________________________
City/ST/ZIP: ________________________
Phone: ____________________________
E-Mail: ___________________________
O Please check here if you'd like the
registration confirmation and the update sent by email. If you choose this
option, you do not need to send a SASE. Please print legibly.
For credit card payments only:
Account #: _________________________
Exp. Date: _______ Circle: MC / VISA
Signature: _____________________________
|
|
| Adult Weekend Membership ($65) |
$_______ |
Youth Membership ($15)
(for children ages 5-12) |
$_______ |
| Adult Friday Only Membership ($20) |
$_______ |
| Adult Saturday Only Membership ($50) |
$_______ |
| Adult Sunday Only Membership ($40) |
$_______ |
Supporting Membership ($10)
(non-attending, incl. program book and badge) |
$_______ |
| Badge numbers for one day memberships will be numbered after weekend badges.
|
| Total this section |
$_______ |
|
Photo Ops
Photo Ops are being offered with our celebrity guests.
Photo Ops will be announced as guests are confirmed.
|
| George Takei ($30) |
______ |
$_______ |
| Malcolm McDowell ($35) |
______ |
$_______ |
| Jewel Staite ($35) |
______ |
$_______ |
| Mark Sheppard ($30) |
______ |
$_______ |
| W. Morgan Sheppard ($30) |
______ |
$_______ |
| Group photo with W. Morgan & Mark Sheppard ($50) |
______ |
$_______ |
| Kate Hewlett ($30) |
______ |
$_______ |
| David Hewlett ($35) |
______ |
$_______ |
| Group photo with Kate & David Hewlett ($55) |
______ |
$_______ |
| Leah Cairns ($30) |
______ |
$_______ |
|
Official Shore Leave 30
T-Shirts (offered by pre-order, to be picked up at the convention), $20
Sizes available are S-4X (4X available by pre-order only).
|
|
| #Shirts |
Size |
|
| _______ |
______ |
$_______ |
| _______ |
______ |
$_______ |
| _______ |
______ |
$_______ |
|
Official Shore Leave 30 Bunny ($10)
(Includes this year's shirt, pre-orders to be picked up at the convention.) |
______ |
$_______ |
Official Shore Leave 30 Bunny Shirt only ($5)
(Shirt only, pre-orders to be picked up at the convention.) |
______ |
$_______ |
|
| Total this section |
$_______ |
|
|
Send More Information About:
Masquerade: __ Art Show: __
Blood Drive: __ Filking: __ Gaming: __
Child/Youth Programming: __
I Can Help With:
Art Show: __ Registration: __
Security: __ Blood Drive: __
Thu PM/Mon AM Manual Labor: __
Anything you need: __
Fan Clubs You Belong To:
___________________________________
Fan Panel Topic Suggestions:
___________________________________
___________________________________
|
US funds only! |
|
| Total Enclosed: |
$_______ |
Mail this form to: Shore Leave 30, PO Box 6809, Towson, MD 21285-6809.
|
|
Refund Policy: Con memberships are not transferable. Workshops
are not refundable unless said workshop is cancelled. No pre-registration
refund requests will be honored postmarked after July 1, 2008. Exceptions to
these policies can be made at the committee’s discretion on a case-by-case
basis.
