HomeGathering

Registration Form
20th Annual Northcoast Men's Gathering
 June 4th - June 6th, 2010

Sliding Scale: $0 - $220
(Our cost is approximately $100 per person)

*Amount To Pay $
*Name 
Address 
City 
State 

Zip 

*Home Phone

Work Phone
*Email Address
*Year of Birth
I can offer a ride from 
I need a ride from 
I prefer the following food type Meat   Vegetarian
I have these dietary
 or physical restrictions:
I would like a T-shirt for $10 Size
Are you willing to help work with/supervise the kids at some point during the weekend? Yes   No
Where did you hear about the Gathering?

(We need your T-shirt order in advance:
there may not be extras.)

*Financial support is available:
call Marc at (707) 839-4817 or Bob (707) 444-8764 to discuss your needs.


Please mail your check for the above amount to:
NCMG
PO Box 2505
McKinleyville, CA 95519