60's Celebration Registration Form Print this form out and mail in the completed form with your payment, Name _____________________________________________________ Address ___________________________________________________              City ___________________________________      State ________   Zip _______ Registration per person:  $30 Includes:  Name badge and Lanyard           Entrance to band Friday and Saturday nights           Celebrate the 60’s logo Tee Shirt      Tee shirt size ____________________             Band entrance only Friday and Saturday nights $10 per person Total amount enclosed ___________________________ Return completed form to: “Celebrate the 60’s”             PO Box 151644             Ely, NV 89315 Makes checks payable to Celebrate the 60’s. Sorry no credit cards.