| PLAYshop Registration
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January 16th-18th, 2009
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| Mailing
Address
City
State Zip |
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| Home
Telephone
Daytime Telephone |
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| How did you find out about this PLAYshop /
Original Play? |
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REGISTRATION
RATES
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| # of People |
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x |
Early Bird Special $165 by Dec. 21st
$200 per adult (19+
years) before 1/5/09
$250 per adult after 1/5/09 |
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$________ |
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x |
$100 teens (13-18
years) |
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$________ |
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TOTAL
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$________ |
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| Check enclosed for
full amount: Check #_________ Amount $_________ |
| Payable
to:
Original Play Northwest
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Payment
Information: Sorry, no credit cards accepted.
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Phone:
(425) 771-4994
Mail registration form with check to:
Original Play Northwest
Attn: Insui - PLAYSHOP Registration
22603 90th Ave W.
Edmonds, WA 98026
In the unlikely event of cancellation all registration fees
will be returned.
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