Twilight Covening 2004 Registration Form

Please print clearly and include full payment with registration.

No registrations or refunds will be considered after September 27, 2004.

Name: ____________________________________________________________ Date: ________________
Address: _______________________________________________________________________________

City: ________________________________________________ State: ______ Zip: ___________________

Telephone: (h) __________________________________ (w) ______________________________________

E-mail address: ___________________________________________________________________________

Can we e-mail your confirmation, directions, and clan information to you? ___ Yes ___ No

(If yes, we will not mail these by US Postal Service; you will only receive e-mail.)

Registration: $250 by September 27		$ ________________
EarthSpirit member discount -$5		$________________	EarthSpirit Member # _____
Total Enclosed:		$ ________________

Payment:___ Check or Money Order ( payable to Payable to Tamelin Productions)

___MC/Visa Card #: ___________________________________ Exp. date: _________________

Cardholder Signature: _____________________________________________________

All credit card payments must include the name as printed on the card and the billing address, if different from registration information above. Bounced checks and declined credit cards may be subject to an additional $25 fee.

Cardholder Name and Address: ___________________________________________________
____________________________________________________________________________

Housing: You will be able to choose a bunk when you arrive at the gathering. Please indicate here if you have special needs or preferences so we can plan ahead. For example, tell us if you wish an all male, all female, or mixed cabin. Please note that some clans will be sleeping together in a clan cabin, so check the clan descriptions.

Food: Do you prefer ___ vegetarian ___ non-vegetarian (we will have both)

Rides: We can try to help arrange rides; however, you are responsible for your own transportation.

I need a ride ___ I can provide a ride for ____ people.

Clan Choices: Please list your first 4 clan choices in order of preference:

1) ________________ 2) ________________ 3) ________________ 4) ________________

Please answer the following questions on the back of this form.

1. How many times have you attended Twilight Covening?
If you attended last year, what clan were you in?

2. How long have you been formally involved with magic or earth-centered spirituality?
What sort of training have you pursued and who have you studied with?

3. If you have chosen a clan marked with an *, please described what training or experience you have had that prepares you for participating in that particular clan. Attach an additional sheet.

By submitting this Registration Form, I agree to hold harmless Tamelin Productions, EarthSpirit Inc., EarthSpirit, and the owners and staff of the site, from any responsibility for personal injury or loss or damage to personal property incurred by myself or my children while attending Twilight Covening.

signature and date: _____________________________________________________________________