REGISTER and PAY BY CHECK

JANUARY ADVENTURE 2019


Print this form, fill it out and send by US mail with your check to:

January Adventure

P.O. Box 20581

St. Simons Island, GA 31522

NOTE: Your Registration by Check is not guaranteed until you receive a confirmation email due to the "delay" with "snail-mail". Registrations by Credit Card are received faster.


Your Name/s                                   Name to use on your name tag

_______________________        ____________________________

_______________________        ____________________________

_______________________        ____________________________

_______________________        ____________________________

 

City, St Zip ______________________________________________

 

(We request an email address for each person.)

Email address    ____________________________

Email address    ____________________________

Email address    ____________________________

Email address    ____________________________


(We request a phone number for each person.)

Phone Number ____________________________

Phone Number ____________________________

Phone Number ____________________________

Phone Number ____________________________


The registration fee is $137.5/person

Check No._______ payable to January Adventure (circle one of the following):


          For one person $137.50,        for two persons $275.00,


          For three persons $412.50,   for four persons $550.00.


Do you require HEARING HANDICAP SEATING?    Yes/No

Do you require a WHEELCHAIR SPACE?                  Yes/No


Go to the VENUE tab on the menu bar for room and board options.