SerpentStone Online Pre-registration


Lammas 2005 Gathering Form

Please fill out and submit one form for each person who will be attending the gathering. (This includes all children.) This information is used to pre-print your Gathering Release Form, which will save you time when you arrive at registration and check in. Your registration will be valid only after your check or money order has been received and processed, and it must be postmarked BEFORE the appropriate deadline date.

If you would prefer to mail in your pre-registration, feel free to fill out the form and print it without submitting it. You will need to send your check or money order (made out to SerpentStone) along with the printout of the completed form to:

SerpentStone
P.O. Box 9296
Knoxville, TN 37940

Gathering Fee:
$10.00 per child* age 12-16 (plus your feast contribution and 2 hours of community service)
if postmarked and paid before August 5, 2005
$15.00 per person** over 16 (plus your feast contribution and 2 hours of community service)
if postmarked and paid before August 5, 2005

(Pre-registered / Pre-PAID for above prices, please)

$25.00 per person** after August 5th and at the door (plus your feast contribution and 2 hours of community service).

*Children under 12 are free. Anyone under 18 must be accompanied by a guardian. If not a custodial parent, the guardian must be responsible for the minor, and have a written permission statement from the parent, which must be presented at registration immediately upon arrival.

**Work-scholarships (in which the registration fee is waived in return for a number of extra work shifts) are available for those for whom finances are an issue. Contact the Registration Coordinator to make arrangements.

All gatherings fees are non-refundable. However, if you have pre-paid and are unable to attend the gathering, you may contact us before the gathering, and your fee can be applied to a future gathering.

FILL IN ALL FIELDS PLEASE
**Denotes a required field.

**Your Legal Name:
Nickname/PIC:
Group/Coven Affiliation
**Mailing Address Line 1:
**Mailing Address Line 2:
**City:  **State  **Zip
Phone Number:
**Email Address:
(needed for confirmation of pre-registration)
**E-mail Format
Home Page Address:
**Birthdate:   Month  Day  Year
Dietary preference (please select one):  Vegetarian   Omnivore
Emergency Contacts (mundane names please):
**Onsite
**Offsite
**Phone
Health or Medical Concerns:
This is where you tell us about any health problems, food allergies, other allergies and the like that you might have.

Special Skills:
Are you CPR certified? A doctor or nurse or other medical professional? Do you know American Sign Language or a foreign language? Please let us know what skills you might have that could help us out.

I would like to register as a merchant at this gathering. I understand that this is an additional $10.00 added to my registration price, and have included it with my pre-registration payment. I also understand that I have to fill out a Merchant Contract before I am allowed onsite.

This form is for a Child under 12
**Parent or Adult Responsible for Child:

Minors not accompanied by their parents must have a signed permission slip from at least one parent and be supervised at all times by their guardian(s).

Comments or Questions:

Community Service: We would like to provide an opportunity for you to pre-register for your community service at this gathering. We need volunteers to sign up for shifts as Heralds and Renaissance Persons. If you're willing to work in one of these positions, please use the box below to tell us:

  1. when you will be arriving at the gathering,
  2. which position you would like to work (only Herald or Renaissance Person please),
  3. a 4-hour block of time when you would be available to work (you will only have to work two of the four hours, but we need a ballpark time to work with for scheduling).

Please note: you will be contacted via email to confirm your shift. If you do not hear from someone, you have not been scheduled. Also, if you are assigned a shift and subsequently do not appear to work, we reserve the right to assign you to the next available shift.

We greatly appreciate your willingness to help make this gathering a wonderful event for everyone!



       


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