[ Event Cancelled ]

HRH Nicholas de Vere and the Royal Dragon Court

FEBRUARY 19 & 20, 2005 at The Granada Forum
5657 Lindley Ave. Tarzana, Los Angeles, CA
St. Innocents Church

REGISTRATION: Step 1

(To complete registration you will need to pay via check or with a credit card though Paypal)

Identification Details:

NOTE: please submit seperate registrations for any participants with differing addresses or telephone numbers. Please make Person 1 the head of the party and send us their contact information so we can confirm your reservations and communicate any event changes.

Name of individual registering
(
Everyone must register as we need to know who is coming as seats are limited, and if they are eating with or not)
Full Name:

Contact Info:

Street Address:
City:
State/Province:
Postal/Zip Code:
Country:
Telephone:
Alt. Telephone:
Fax:
Email:
Please enter comments or explanations regarding identification details:

Pre-registration Event Choices:

All you can eat meals include:
Coffee, tea, juices throughout the day.

Breakfast: assorted pastries, bagels, cream cheese, fresh fruits.
Lunch: Sandwiches, fresh fruits.
Dinner: Italian; with all you can eat, pies, cakes for dessert.

* For vegitarians please make note in comments area below.

day 1 only (FEBRUARY 19)
with food $112
without food $90
day 2 only (FEBRUARY 20)
with food $112
without food $90
Both days
with food $200
without food $170

Please calculate your choices and enter below:

TOTAL DUE$
Please enter any additional comments, explanations special accomodation requests below or feel free to call us at (808) 222-2453 send E-mail to info@ancientwisdom.net for further information or assistance

Please print this page now if you would like a record of your registration.