How to use this form

 

         
First Name* Last Name*  
 Address 1*     
Address 2        
City* State* Zip Code*
Home Phone   Business Phone
           
Email*    
           
  Kaiser Finisher* Yes
No		    
         
  *Qty Kaiser Registration  @ $72.00 before 5/28 and $87 after 5/28
  *Qty Tollhouse Registration  @ $52.00 before 5/28 and $57 after 5/28
  *Qty Millerton Registration @ $42.00 before 5/28 and $47 after 5/28
         
  Qty T-Shirt (optional)  @$15.00    
         
  Qty Finishers Jersey $68.00    
         
  Qty Additional Lunch @$10.00