Echoes In Time
                            Registration

                        (Please Print Clearly)

   Name ___________________________________________ Date ____________
   
Address _____________________________________________________________

   City ____________________ State/Province ________ Zip ____________


Phone (______) ___________________  Email ___________________________


Arrival Date _____________________


Where did you hear about Echoes in Time? ____________________________

I have attended Echoes in: 00  01  02  03  04  05  06  07  08  09  10


Number of Persons Attending:

                       Adults: ___________ x $150 = _________________

                Children 6-13: ___________ x $75  = _________________

         Children 5 and under: ___________


  Late fees for registration postmarked after June 30th: ____________
                       ($25 per adult, $12.50 per child)


       Total number of people: ___________    Total $________________

       (day rate: $40 for adults, $20 for children 6-13)
    

Tent ________     RV or Trailer ________ (no hook-ups available)

Total number of vehicles ________