Registration Form

 

Registration Form

Print form and fill out all information as requested and send to the address below along with check payable to Phoenix. Please use one form per person. Also have mercy on our reg person and print legibly or you badge name may end up being “Njebti&v@#”

Name:

Street Address:

City:

St:

Zip:

e-mail*:

Birthdate:                       /                         /

Phone:

Badge Name:

Type of registration (choose one): Adult      Child

Adult – $45 postmarked thru January 31st. $50 postmarked February 1st thru August 31st. $55 there after
Child (4-12 ) – $30 postmarked thru January 31st. $35 postmarked February 1st thru August 31st. $45 there after
Under 4 free

*By giving your e-mail address you agree to receive occasional e-mails from Dellacon/ISFiC with updates and information about the convention.

Your privacy is important to us your information will not be shared with anyone else.