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*

Rater Fest 2009 Registration

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