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EnergyLogic
Rater Fest 2009 Registration
*Required fields.
Name:
Company Name:
Address:
City:
State:
Zip:
Email Address:
Phone:
Alternate Phone:
Who Will Attend?
# of Raters:
# of Other Adults:
# of Children:
Please list names of attendees here:
Any dietary restrictions?
Will you be camping or lodging locally?
Camping
Lodging in a Local Motel/Hotel/B&B
Other Arrangements
What are you hoping to learn from this event:
Other comments or questions:
Early-Bird Special: $150 for Raters through July 11th!
All-Inclusive Registration Fees (after June 1st)
Rater: $200
Each additional adult: $50
Each additional child (ages 4-12): $25
Each additional child (3 and under): Free
Total Payment Amount:
*Payment Method
Check
Payable to "EnergyLogic, Inc". Please mail payment to:
EnergyLogic Inc.
P.O.Box N
Berthoud, CO 80513
Credit Card
Please call 800.315.0459 x719 or x734 to submit your Visa or Mastercard information over the phone.
Enter Verification Code*
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