2016 NSS Convention Registration

Please type or print legibly. Use one form per Please mail registration form and your check or
person. All participants must review and sign money order to: NSS 2016 Convention
liability waivers at registration. We reserve the
right to remove any persons whose behavior 9032 Black Elk Avenue
infringes on the safety of our other guests. Las Vegas, NV 89143-1122
Participant Information Full-Week Registration
Name NSS # Before June 1st: Adult, NSS Member o: $175.00
Youth (9-17) (incl. JSS, no guidebook) o: $120.00
Mailing Address Child (0-8) o: $28.00
June 1st - July 1st: Adult, NSS Member o: $190.00
City State Postal Code Youth (9-17) (incl. JSS, no guidebook) o: $130.00
Child (0-8) o: $28.00
Country Age: o 0-8 o 9-17
o 18-20 o 21+ Onsite Registration: Adult, NSS Member o: $200.00
Youth (9-17) (incl. JSS, no guidebook) o: $135.00
Daytime Phone Evening Phone
Child (0-8) o: $32.00
E-mail Address Radio Callsign? NSS Non-Member Surcharge o: $45.00
Meal Plan (served M-F at the high school) o: $95.00
Name as it should appear Includes breakfast and lunch Monday-Friday
on registration badge: Day-Pass Registration
Day passes include daytime sessions and evening social
Emergency Contact & Considerations functions, but no camping or guidebook. All passes must be
Contact Name NSS # shown at the entry gates each day.
Monday, July 18 o or Friday, July 22 o: $58.00
Daytime Phone Evening Phone Tuesday o, Wednesday o, Thursday o: $45.00
Special Events
Are you mobility impaired? o Yes o No
Are you hearing impaired? o Yes o No
Please visit our website for details. Most events will be in Ely,
NV, but the NNSS tour departs from Las Vegas on the 15th.
Any medical conditions we
should be aware of? Fri. Jul. 15: NV National Security Site Tour o: $16.50
Sat. Jul. 16: Ely Speleo-Fest o: Free
Preferences & Special Requirements Sun. Jul. 17: Geology Field Trip o: $55.00
Drink preferences: o Wine o Coffee o Light Beer o Dark beer Tue. Jul. 19, 4:30pm: Geology Steam Train o: $22.50
o Milk/juice o Diet soda o Regular soda
Tue. Jul. 19, 7:30pm: Geology Steam Train o: $22.50
Dietary restrictions or allergies?
Date TBD SpeleoArt Workshop o: $20.00
Wed. July 20: Photography Workshop o: $12.00
Special requirements?
Thu. Jul 21: Vertical Workshop o: $25.00
Fri. Jul 22: Speleology for Cavers o: $45.00
Accommodation & Gear Plans Sun-Fri, 9:30am: Steam Train Excursion o: $18.00
To help with our planning, where will you be staying:
o Sun, o Mon, o Tue, o Wed, o Thu, o Fri.
o Camping (tent) o Camping (RV) o Local hotel o Other
Would you be interested in RV hook-ups for $25/day? o Yes o No Merchandise & Extras
Travel plans: o Flying o Driving o Private aircraft NSS 2016 Convention T-shirt: o Mens o Womens
Will you need to borrow cave gear? o Yes o No o Small, o Medium, o Large, o X-Large: $12.00
Would you like the Nevada Commission on Tourism to send you a o XX-Large, o XXX-Large: $14.00
free travel guide? o Yes o No NSS 75th Anniversary Pin Free
NOTE: All cavers from WNS-impacted areas are encouraged to leave Free for all registrations received by April 22! Until Apr.22
their personal gear at home. Decontamination is required for all trips! NSS 75th Anniversary Coffee Mug o: $12.00
ALSO: Ride sharing information is available on our website.
NSS 75th Anniversary Book o: $25.00
Payment Information 2016 Convention Cloisonn Pin o: $6.00
2016 Convention Patch o: $7.00
o VISA o MasterCard o Discover o Check/Money Order
All payments should be made to: NSS 2016 Convention Extra Guidebook o: $28.00
Pet Registration (includes free gifts!) o: $24.00
Card Number CCV Code
Pets Name & Species:
Name on Card Expiration Date Discounts
Current College Student (must show ID) o: - $25.00
Billing Address No Guidebook o: - $28.00
Only available for secondary registrations at same address.
Billing City State Postal Code
NSS New Member Coupon o: - $45.00
Signature
Total Registration:

The 2016 NSS Convention is an internal committee of the National Speleological Society. Visit us online at nss2016.caves.org