LEATHERFEST X REGISTRATION FORM Please print clearly ********************************************************************** Legal Name(as it appears on picture ID)________________________________________________ Preferred name on nametag (max 15 characters)___________________________________________ Street Address________________________________________________________ City_____________________________________State________Zip_____________ Phone Evening(_______)___________________Day(_______)_________________ Email ________________________________________________________________ I am 21 or older__________________________________(Signature required) ********************************************************************** Please mark an "X" where applicable ___TORTURE This full-package includes FetishLounge, BOTH DungeonFests,Dinner & Fashion Show, Workshops, Fetish Bazaar, LeatherFest X Pin & LeatherFest X T-shirt (T-shirt size - __S __M __L __XL __XXL __XXXL) Before Feb. 1 - $165 Before Mar. 1 - $175 At the Door --- $185 ....................Total $_________ ************************************ ___TITILLATE This package includes FetishLounge, ONE DungeonFest, Dinner & Fashion Show, Workshops, Fetish Bazaar, LeatherFest X Pin & LeatherFest X T-shirt (T-shirt size - __S __M __L __XL __XXL __XXXL) DungeonFest choice __Friday or __Saturday Before Feb. 1 - $135 Before Mar. 1 - $145 At the Door --- $155 ....................Total $_________ ************************************ __TEASE This package includes FetishLounge, Dinner & Fashion Show, Workshops, Fetish Bazaar, LeatherFest X Pin & LeatherFest X T-shirt (T-shirt size - __S __M __L __XL __XXL __XXXL) Before Feb. 1 - $105 Before Mar. 1 - $115 At the Door --- $125 ....................Total $_________ ************************************ __TEMPTATION __Friday's Day-Pass includes FetishLounge & Fetish Bazaar __Saturday's Day-Pass includes Workshops & Fetish Bazaar __Sunday's Day-Pass includes Workshops & Fetish Bazaar Before Feb. 1 - $35 each day Before Mar. 1 - $40 each day At the Door --- $45 each day Number of Days ______ X Price per day _______ = Total $________ ********************************************************************** CHECK ONE ___Check ___Money Order.........GRAND TOTAL $________ .........(Payable to LeatherFest X) MAIL TO: LeatherFest X, P.O. Box 3092, San Diego, CA 92163 ********************************************************************** Please mark an "X" where applicable __I require American Sign Language interpreting. __Enroll me in SM University (please read requirements). __I am interested in 12-Step program. __Please send me information on volunteering. __I am interested in giving a workshop. __I am interested in being a vendor. __Please check here if, under the Americans with Disabilities Act, you require any auxiliary aids or services. Please attach requirements and submit with this form ********************************************************************** All mail-in registrations MUST be postmarked on or before indicated deadline to take advantage of discounts. No mail-in registrations will be accepted after March 1, 1998. AT DOOR prices are based on availability. Persons may attend DungeonFest only by purchasing either TORTURE or TITILLATE packages. Do not mail AT DOOR registrations. Registration fees are not refundable after February 5, 1998. ********************************************************************** One form per individual. Copies of this form are acceptable.