Click the above button to "Print This Form". This should open up your print window and print the form. Once the form has printed, please complete ALL information using an ink pen. Please PRINT LEDGIBLY!! If you encounter a problem printing, you can open up the Form in PDF Format (You may also Right Click and Save As if you need)
Your Legal Name MUST match your Legal Government Issued ID. Be sure to bring your ID with you to the event as you will not be allowed to enter without it.
Please print and complete a separate form for each registrant.
- ______________________________________________________
- ______________________________________________________
- ______________________________________________________
- ______________________________________________________
- ______________________________________________________
- ______________________________________________________
- $125.00 _______________________________________________
- Legal Name:
- Street Address:
- City:
- State & Postal Code:
- Badge Name:
- Email Address:
- Amount Enclosed:
If paying by check, mail this completed form with your check or money order made out to:
B.R.Baldwin730 Odom Dr
Fayetteville, NC 28304
If paying by PayPal or Credit Card, complete this form and mail it to the above address. Once the form is received, we will send you an invoice via Pay Pal to your email account. If you have a Pay Pal Account, we will send it to your Pay Pal Email Address listed below giving you the options associated with your Pay Pal account (i.e. credit card, check card, Pay Pal, etc...). If you do not have a Pay Pal Account, you can still Pay with a Credit Card via the Pay Pal Invoice we will send you via your email listed above.
Please Note: If you want to use your Pay Pal Account keep in mind Pay Pal uses an email for it's account login and account information. We realize that not all of us will use the same email for Pay Pal as one might for kink and personal uses. With the exception of payment invoice and confirmation from the Pay Pal System, We will NOT send correspondence to your Pay Pal Account Email (unless it is the same as your registration email address listed above on this registration form).
If your Pay Pal Account Email is different than your registration email, be sure you list it here to allow us to send you an invoice for payment. Payment MUST be received or your registration from must be postmarked by each payment deadline to quality for that rate.
- ______________________________________________________
- PayPal Email:
- ______________________________________________________
- ________________________
- Signature:
- Date: