Registration Form (Print out and mail in)

Name#1_____________________________________Program (AA, Al-anon, other)________________________

Name#2_____________________________________Program (AA, Al-anon, other)________________________

Address________________________________________________Apr.Space_____________________________

City______________________________State__________Zip________Phone_(______)____________________

Pre-Registration by (3/24/08) (_________) x $5.00=$___________________________________

Registration after (3/24/08) (___________) x $7.00=$___________________________________

Dinner(________)x$7.00=$_______ Breakfast (_______)x4.00=$______________

Total Enclosed$_____________________________________

MAKE CHECKS PAYABLE TO: West Valley Roundup, P.O. Box 5495, SunCityWest, AZ 85376

Will you be camping?_____________________