Norwescon 25 Art Show
C/O Tracy Knoedler
6531 95th ST NE
Marysville, WA 98270

Please, fill out a separate form for each person age 13 and over attending the convention. Members will be asked for photo identification and signature when checking in. You will not be added to the Norwescon email list from this form.

Suggestion - Make a copy of this form, and/or your confirming email, and a copy of your method of payment (check, money order), save it, and take it with you to the convention. Just to be safe. Please print clearly, thank you.

Name _______________________________________________________________________

Badge Name __________________________________________ Birth date ____/____/_____

Address _____________________________________________________________________

City _________________________________ State/Prov __________ Zip/PC ______________

Phone (______)_________________________ Email _________________________________

Names of children 12 years and younger (Admitted free with a paying adult member), please include age the child will be at the time of the convention.

_________________________________________________ Birth date _____/_____/_______

_________________________________________________ Birth date _____/_____/_______

I agree to abide by the rules and policies of Norwescon.

Signature ____________________________________________________ Date __________

____ Attending Artist ($35 convention membership)

____ Non Attending Artist ($25 convention membership)

____ General Attending Membership ($50)

(Make checks payable to Norwescon)