| REGISTRATION PAGE To make reservations to the Illinois State Twins Convention please fill out this registration form. All information will be held in strict confidence. Meal reservations must be received by April 15th. _________________________________________________________ Twin #1 Name________________________________ Address _______________________________________ Phone __________________ E-Mail________________ Twin #2 Name________________________________ Address________________________________________ Phone___________________ E-Mail________________ Name of Parents or Guardians of twins under age 18 ______________________________________________ LUNCHEON COST ____Adults (13 +) x $16.00 = _________________ ____Kids (5-12) x $9.00 = __________________ Children 4 and under are free! ANNUAL DUES PER TWIN _____Adults (13 +) x $7.00 = ________________ _____Kids x $5.00 = _______________________ TOTAL ENCLOSED ______________________ Make checks or money orders payable to: Illinois State Twins Association Mail to: Michelle & Nichelle Bricker 711 West Jackson Sullivan, IL. 61951 |