Registration Form

Friday April 9 & Saturday April 10, 2009

Name: ____________________________________________________________________________________________

Address: __________________________________________________________________________________________

City: ________________________________________________ *State: _____________ *Zip: _____________________

Telephone: _______________________________ Email Address: ____________________________________________

Name(s) for Badges (please print clearly): ______________________________________________________________

__________________________________________________________________________________________________

Payment
(Make checks out to "IBM RING 50") Registration includes one ticket to the Saturday evening gala show.
NOTE: Children under 16 must be accompanied by a paid adult. Cash or Checks ONLY AT THE DOOR.

EARLY: Through March 21, 2009 Admission: $50.00. REGULAR: After March 21, 2009 & at the Door: $65.00.

GALA SHOW TICKETS are $12 each ($15 at the door), Students (<14) and Seniors (65+) $10 and $15 at door

Total number of people registering: _____________ x $ _____ = $ ______________

Total number of Adult Gala Show Tickets __________ x $ 12.00 = $ ______________

Total number Student/Senior Show Tickets ________ x $ 10.00 = $ ______________

Total Amount Enclosed: $______________

 Paying online with a credit card. (Please provide PayPal transaction number.)

Payment Methods:
Credit Card via Web site ONLY. Send money on PayPal.com to <MagiWhirl@IBMRing50.org>.
Please PayPal transaction number.

Mail: [ ] Check or [ ] Money Order is enclosed payable to "IBM RING 50"

PLEASE NOTE: NO CHECKS, MONEY ORDERS OR E-Checks postmarked after March 21, 2009.
(To receive your confirmation email by April 8, 2009, please mail this form by March 30 to ensure pre-registration.)

Mail to: Magi-Whirl 2010

C/o Bob Patterson, Treasurer
3450 Wainscott Place
Lake Ridge, VA 22192