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DUCKSTOCK

"The Party"

Your "Premier" Adult Party

April 24 - April 27, 2008

Registration

duckstocktheparty@gmail.com
* = Required Fields
*Name (1):
*E-Mail Address (1):

Name (2):
E-Mail Address (2):

*Address:
*City: *State: *Zip:

Home Phone:
Cell Phone:
Work Phone:

Any allergies or medical problems we should know about?
 

 

We will need a Picture ID when checking in the Gate for age Verification. Absolutely NO ONE under the age of 18 will be allowed.

The gate will be closed from 12:30 am until 7:00 am. If you will be arriving then please contact PaPa James.

 

Are you interested in vending? Please contact PaPa James by phone after registering @706 291 2385.

 

GENERAL WAIVER AND INFORMED CONSENT TO PARTICIPATE

*(1) I,
and (2) I,
having read and understood the Rules and Regulations and standards of conduct expected while at Dragon Hills, freely consent to these. Being a voluntary participant at Duckstock "The Party" 2008, at Dragon Hills , Georgia, , 2008, I agree to abide by the above rules and regulations. I also understand that if I do not abide by these, I may be escorted from the site without refund. I also agree to hold harmless the owners of the site of Dragon Hills, the organizers and staff of Duckstock "The Party" 2008 and all its representatives, from all claims, actions, expenses and demands in respect to injury, loss or damage to my person or property, however caused, arising in connection with my participation even if the same may have been contributed to or occasioned by the negligence of the owners, the said body, or of any of its representatives.

 

Please type your full legal name below; this will be your electronic signature)

*(1) Signature
*Date signed:

*(2) Signature
Date signed:

Method of Payment:
I will be mailing a check or money order by March 31 , 2008 (paying whatever the current price is when I mail my check)
I will be paying at the gate ($50 money order)
I will be paying with PayPal. (Current Price)

If you would like to be a Vendor at Duckstock "The Party" please contact "Papa" James Milddleton @ 706-291-2385

PLEASE PRINT A COPY OF THIS PAGE ALONG WITH PAYMENT AND MAIL  TO:

James Middleton, 623 Flatrock Rd., Rome, GA 30161

Or fill out form then click the Submit button to register now and pay (whatever price is at the time) later

If paying via PayPal, please use form below.

 

 

*If mailing this form with a check, or money please note below what you are paying for.
(NOTE: Current price only good if payment accompanies registration.) Prices per person:
 

                                                                                                                                                                                                  

Members of Duckstocktheparty 2007
           $25.00
Postmarked and paid by February 1, 2008
$30.00
 
Postmarked and paid by March 1, 2008
$40.00

 
Thereafter and at gate April 1, 2008
$50.00

NO mail in payments postmarked after    
Vendor Electricity Surcharge (only if using electricity)
$25.00

  Total enclosed:

 
     
                                                                     

Refunds will be given up to April 15, 2008, with $15 per person surcharge that will  not be refunded.  After April 30, 2008, there will be no refunds.

*Please make checks and money orders out to James Middleton and mail to 623 Flatrock Rd., Rome, GA 30161