West
Virginia State Fairgrounds
Fairlea, WV
Hosted by Bubble Cave LLC
Please
mail this form with your check (payable to Bubble Cave LLC; ‘Spring VAR’ on
memo line) to:
Bubble Cave Spring VAR 2005
Registration
c/o Judy Fisher
PO Box 276
Berkeley Springs, WV 25411-0276
Use
pre-registration prices only if your form is postmarked on or before April 18,
2005. Thank you.
Name______________________________________________________________
Address____________________________________________________________
City_______________________ State____________________ Zip_____________
21 years old or older? Yes/No (Please circle one) Age if under 21_____________
NSS Member? Yes/No (Please circle one) NSS Number______________________
Grotto Affiliations: ____________________________________________________
Do you want a Vegetarian Meal? Yes/No (Please circle one)
VAR
Fees:
Through April 18, 2004 (we will use the postmark):
Adult (15+ years): $27.00 x ____________ = $_______________
Children (5-15): $24.00 x _____________ = $________________
Babies (0-4): Free
Total Amount enclosed: $_________________________________
Cost after April 18, 2005: Add $3.00 per person