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Member
First conference?
Name (#1)_________________________________________________________________
YES NO
YES NO
Name (#2)_________________________________________________________________
YES NO
YES NO
Junior A ____________________________________________________
Age_ ________
YES NO
YES NO
Junior B ____________________________________________________
Age_ ________
YES NO
YES NO
Adult singles:
Early registration (postmarked by 9/15/12)
Late registration (postmarked after 9/15/12)
Adult couples:
(any two adults registering from the same farm)
Early registration (postmarked by 9/15/12)
Late registration (postmarked after 9/15/12)
Juniors (under 18): Registration
$290
$315
#1 #2
#1 #2
$340
$365
. . . . . . . . . . . . .
$495
$530
$200
#1 #2
#1 #2
A B
$550
$580
$200
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$______________
$______________
$______________
$______________
$______________
Partial package 1: Includes all programs and meals for Friday night, Saturday, and Sunday morning.
Adult singles:
Early registration (postmarked by 9/15/12)
Late registration (postmarked after 9/15/12)
Adult couples:
(any two adults registering from the same farm)
Early registration (postmarked by 9/15/12)
Late registration (postmarked after 9/15/12)
Juniors (under 18): Registration
$255
$280
#1 #2
#1 #2
$305
$330
$430
$460
$160
#1 #2
#1 #2
A B
$480
$510
$160
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$______________
$______________
$______________
$______________
$______________
Partial package 2: Includes all programs and meals for Saturday and Sunday morning.
Adult singles:
Early registration (postmarked by 9/15/12)
Late registration (postmarked after 9/15/12)
Adult couples:
(any two adults registering from the same farm)
Early registration (postmarked by 9/15/12)
Late registration (postmarked after 9/15/12)
Juniors (under 18): Registration
$215
$240
#1 #2
#1 #2
$265
$290
$350
$380
$135
#1 #2
#1 #2
A B
$400
$430
$135
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$______________
$______________
$______________
$______________
$______________
Additional information
I would like to purchase a GALA calendar
I/WE require vegetarian meals
#1 #2 A B
I/WE will be attending the Ice Breaker
#1 #2 A B
$15.00 each. . . . . . . . .
$______________
circle if yes
# _____
# _____
# _____
# _____
# _____
$100
$180
$60
$100
$20
$______________
$______________
$______________
$______________
$______________
$1000 . . . . . . . . . . . . .
$500 . . . . . . . . . . . . .
$250 . . . . . . . . . .
$175 . . . . . . . . . .
$100 . . . . . . . . . . . . . .
$50 . . . . . . . . . . . . . .
$25 . . . . . . . . . . . . . .
$______________
$______________
$______________
$______________
$______________
$______________
$______________
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Platinum Sponsor
Gold Sponsor
Silver Sponsor
Speaker Sponsor
Refreshment Sponsor
Fiber Room Sponsor
Friends of GALA
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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$110
$80
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $40
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $25
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $15
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$______________
$______________
$______________
$______________
$______________
#1 #2
#1 #2 A B
#1 #2 A B
TOTAL $______________
conference funDraising:
Items to be donated: _______________________________________________________________________________________
_____________________________________________________________ Approx. value: $_____________________________
Cash donation for llama research. Will bring to conference
payment:
Check enclosed
Make payable to GALA CONFERENCE 2012, c/o Anita Collins, P.O. Box 806, Kutztown, PA 19530-0806
Credit card
Charge my
Visa
MasterCard
Amount: _______________________________________
Acceptance of registrations will be determined by the postmark on the envelope and full payment.
Cancellations with full refunds will be allowed until 10/19/12. Refunds will be made post conference.
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