Pre-Registration Form

Section I - Mailing Information
Mundane Name:

Street Address:
City:
Province/State:
Postal/Zip Code:
Country:
E-mail Address:

 

Section II - Badge Information
Name:

Species (optional):

Please check what days you will be attending:
Friday: $15 ($20 after January 31st) Saturday: $20 ($25 after January 31st) Sunday: $10 ($15 after January 31st) All three days: $40 ($45 after Jan. 31st)

 

Section III - Misc Information
Please check all that apply:
I will need crash space. I am willing to provide crash space. I am willing to provide transportation I will need transportation.
I am interested in the Mongolian Grill lunch trip on Saturday (All you can eat of design-it-yourself stir-fry)

   
I wish to pay in advance for the Mongolian Grill: $20 CDN
Please complete this form, and mail along with a cheque or money order in Canadian funds (made out to Jo Scott) to:
Kinvention North
c/o Jo Scott
29 West Avenue,
Unit 102,
Kitchener, Ontario
CANADA
N2M 5E4