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StarArts Registration Form

Fill in all appropriate blanks. Then click "Review My Information" to check your application. If all information is correct, click "Submit Registration" to register. If you need to change something, back up by pressing "Edit My Information"
(And don't forget to submit your deposit!)

Family name:	(last name for alphabetizing the list)
Address:
City:	State: Zip:
Home Phone:
Email:

Emergency Contact

Name:
Relationship to you:
Home Phone:	Work: Cell:

Enter Each Registrant Below

Room type guide: 1 single occupancy, 2 double occupancy (twin beds), 3 double occupancy (double bed), 4 motel double (ensuite toilet and sink), 5 triple. Requests are honored when possible (please list first and second preference).

Name:	First: Last: Nametag to read:
Birth date:	Occupation: Gender:
Email:	Cell phone:
New?	New to conference New to Island Interested in helping a New Shoaler?
Meals:	Regular Vegetarian
Room:	Type: Ground floor needed Electrical outlet needed, why? Roommate pref: Other needs:

Name:	First: Last: Nametag to read:
Birth date:	Occupation: Gender:
Email:	Cell phone: Relation to primary:
New?	New to conference New to Island Interested in helping a New Shoaler?
Meals:	Regular Vegetarian
Room:	Type: Ground floor needed Electrical outlet needed, why? Roommate pref: Other needs: