Back
to Summer 2004 Announcement
page updated:
28 April 2004
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REGISTRATION
FORM
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![]() Back Tee Shirt Logo |
Registration fee includes one white canvas tote bag with logos and group camp site fees. Tee shirts and denim bags with the logos will be on sale during on-site check-in and late registration.
Name ________________________________________________________________________________________
Address ______________________________________________________________________________________
Telephone (________)_______________________
USAS Chapter or UPAC
________________________________
Number |
Event |
Cost |
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______ |
$15 per person registration before May 15, 2004, late registration $20 per person. Registration fee includes one white canvas tote bag with above logos. |
= $______ |
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______ |
for Friday hamburger fry (free by UPAC, but we need to know numbers) |
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______ |
for Saturday Navajo Taco lunch (pay on-site, but we need a ballpark figure) |
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______ |
Please indicate if you are interested in the ATV ghost town ride |
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______ |
$20
for Banquet at the River Cookhouse in Marysvale Canyon. Please note
your
menu preference,
includes tax & tip. Indicate entree
choice: |
= $______ |
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Medium blue tee shirts with navy at neck and sleeves, printed with logos. The shirts are 50/50 blend to avoid shrinkage, but sizes run a bit small. |
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______ at $10 apiece for ______ medium ______ large ______ x-large |
= $______ |
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______ at $12 for xx-large ______ xxx large |
= $______ |
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TOTAL
DUE $_________________
Make checks payable to USAS Convention
Return
by May 15 to:
USAS Convention, c/o Viva Meyer
813 Medoland Drive, Brigham City, UT 84302