REGISTRATION FORM

5th Annual Child-Free Festival
June 15-18, 2006

  NOTE: Each Registrant must fill out a separate Registration Form, print and mail to:

Heather Pearce c/o Toronto NK
155 Tycos Drive, Unit 44
Toronto, ON, M6B 1W6

  If paying by check or money order as indicated below, include this with your
  completed Registration Form, payable to Heather Pearce.

  If paying by Paypal/credit card, each Registration must fill out the form and
  select payment by Paypal/credit card separately.

  NOTE: Payment must be received within 7 days of registration.
  Payment is non-refundable.

  Name: (First name,
  Last name)

  
  Street Address:  
  City:  
  State/Province:  
  Zip Code/Postal Code:  
  Telephone (with area
  code):		  
  Cell phone (with area
  code):		  
  Email Address:  
  NK! Chapter Affiliation:  

  Breakfast on Friday:
  (Note: This will be
  charged to your
  hotel room invoice.)

Yes 
No  

  US Residents:

  How will you pay your
  registration fees:

 International Money Order in Canadian Dollars by Mail (payable to Heather Pearce)
Paypal / Credit Card

  Canadian Residents:

  How will you pay your
  registration fees:

  Cheque / Money Order (payable to Heather Pearce)
  Paypal / Credit Card

  Niagara Falls Tour on
  Sunday (optional)

  ($81 CAD):

 Yes
No
  Special Requests/ Comments:
 (please indicate if you require a vegetarian meal for the Saturday dinner)		  

Pay by PayPal/Credit Card