Registration Form:

Two Methods to Register: 

Prink this page and send a check payable to Timothy Walters at the address below or pay by card through the link below.

Name         ___________________________________

Affiliation  ___________________________________

Address _____________________________________  City & Zip Code  ______________________________________

Phone  ______________________________________   Email*  ________________________________________________

 

*Your email will be used to send acknowledgement of your registration and any updates that may occur.

Mail checks to:  Timothy Walters, 15608 NE 5th Street, Vancouver, WA  98684