Camelids Warm Our Hearts

Conference 2012 Registration Form

* C onsider joining GALA: For the cost of membership

($40 for the July-June period), adults save up to $50

when registering for this conference. Plus, you gain
the benefits of receiving the GALA newsletter and
membership directory, as well as having access to
the GALA library. (See reverse side for more info.)

Name(s) as you want them to appear on name tag(s):

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

Farm name ______________________________________________________ Email _ ______________________________________

Address_ _______________________________________________________________________________________________________
City_____________________________________ State ________ Zip _______________ Phone ______________________________
Circle #1 and/or #2, A, or B (corresponding to the names above) to indicate which person is registering for the following:
Full package: Includes all programs and meals for Thursday night, Friday, 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

Member* Circle Non-member

$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

Member* Circle Non-member

$255
$280

#1 #2
#1 #2

$305
$330

$430
$460
$160

#1 #2
#1 #2
A B

$480
$510
$160

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. . . . . . . . . . . . .

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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

Member* Circle Non-member

$215
$240

#1 #2
#1 #2

$265
$290

$350
$380
$135

#1 #2
#1 #2
A B

$400
$430
$135

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. . . . . . . . . . . . .

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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. . . . . . . . .

$______________

Page 1 TOTAL . . . . . . . $______________

Exhibits: (see registration booklet for details)

circle if yes

Vendor space approx. 100 sq. ft., 2 tables, 2 chairs Electric

Full meals only package (per person)
Farm/Product Display (8 x 18 table) Electric
Tent Stall Space (1 stall per farm)
Conference Notebook

# _____
# _____
# _____
# _____
# _____

$100
$180
$60
$100
$20

$______________
$______________
$______________
$______________
$______________

$1000 . . . . . . . . . . . . .
$500 . . . . . . . . . . . . .
$250 . . . . . . . . . .
$175 . . . . . . . . . .
$100 . . . . . . . . . . . . . .
$50 . . . . . . . . . . . . . .
$25 . . . . . . . . . . . . . .

$______________
$______________
$______________
$______________
$______________
$______________
$______________

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sponsorship: Deadline is September 15 if you wish to be listed in the notebook.

For your convenience, if you wish to make a sponsorship payment with this registration.
(See booklet for details on advertisement space and recognition.)

Platinum Sponsor
Gold Sponsor
Silver Sponsor
Speaker Sponsor
Refreshment Sponsor
Fiber Room Sponsor
Friends of GALA

Free full-page tab ad, plus more. . . . . . . . . . .

Free full-page tab ad, plus more. . . . . . . . . . .
Free half-page ad, plus more. . . . . . . . . . . . .
Free half-page ad, plus more . . . . . . . . . . . .
Free 1/4-page ad, plus more . . . . . . . . . . . . . . . .
Free business card ad, plus more. . . . . . . . . . . .
Name recognition in the notebook. . . . . . . . . .

conference notebook advertising: Deadline is September 15.

For your convenience, if you wish to make an ad payment with this registration.
(See booklet for details.)


Full-page tab ad

Full-page ad

Half-page tab ad

1/4-page tab ad
Business card size ad

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$110
$80
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $40
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $25
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $15

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$______________
$______________
$______________
$______________
$______________

volunteers needed during conference:

I/We
are willing to be Speaker Hosts

Suggested speaker to host: ________________________

I/We are willing to help set up on Thursday afternoon.
I/We are willing to help take down on Sunday morning.

#1 #2

PAGE 1 TOTAL $______________

#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

Will send by mail__________________________________________

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: _______________________________________

Card Number: _ ___________________________________________ Exp.Date: ______________________________________

Name on card (print):_______________________________________ Signature: _ ____________________________________

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.

join

or renew GALA membership:

Membership from 7/1/12 to 6/30/13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $40
Download membership form from www.galaonline.org and attach. (See information on the form.)
Please write a separate check.
Check if a renewal
Please make a copy of registration form for your records.