Please complete this form, then you may pay online via paypal or check the contact me box. All fields are required.
Name of the person paying (first and last):
Email:
Who’s in the household (Last Name First – DOB): 1. 2. 3. 4. 5.
Household address:
Phone # for questions?
Check boxes: Family $75 Adult Couple $60 Individual $35 Senior $25 (age 62+) Senior Couple $40 (age 62+)
Payment: Contact me for payment. I will pay via paypal on next screen
