EzzyTime.Com Winter Ride 2012 Registration Form
You Only Have To Submit A Registration Form With First Payment

Please complete and submit or return by mail so we can expedite your registrat

First Name: Middle Initial:
Last Name:
Age: Date of birth:

Contact Number : Optional Contact Number:
Email Address:

Please Select Your Coordinator

Type of room your requesting
Choose The Occupancy of your room (price per person occupying the room) your cost is
Double: Roommate name:First, Last
Triple: Roommate names: Roommate name:First, Last
Quad: Roommate name: Roommate name:Roommate name:First, Last

Payment Amount that you are making after completing registration$ A payment must be made when submitting a registration form.

Please remember all payments are final. There will be no refunds or transfer of money allowed. I will allow name changes.

Date you are submitting this form:

HERE IS AN ATTACHED COPY OF THE PAYMENT SCHEDULE
Payment Schedule 1st Deposit Due April 1, 2011 $50.00 2nd Deposit Due June 18, 2011 $100 3rd Deposit Due August 20, 2011 $50 4th Deposit Due October 15, 2011 $100 Balance Due January 7, 2012 All deposits are non-refundable

Payment #

EzzyTime.Com Winter Ride 2012 Registration Form You Only Have To Submit A Registration Form With First Payment

Copyright © 2003 [Ezzytime.Com]. All rights reserved. Revised: 10/05/11

EzzyTime.Com Winter Ride 2012 Registration Form
You Only Have To Submit A Registration Form With First Payment

Copyright © 2003 [Ezzytime.Com]. All rights reserved.
Revised: 10/05/11