Registration Form
RAJA 2015 – COLORADO SPRINGS 4 – 7 JUNE 2015 REGISTRATION FORM Price Number Attending Registration fee $40 per person ______ $0.00 ______ Icebreaker - Thursday $45 per person ______ $0.00 ______ AFA/Garden of the Gods (incl lunch) - Friday $40 per person ______ $0.00 ______ Cripple Creek (Mine Tour) - Saturday $40 per person ______ $0.00 ______ Alternative: Cripple Creek (Train Tour) - Sat $35 per person ______ $0.00 ______ RAJA Banquet - Saturday $50 per person ______ $0.00 ______ Golf* - AFA - Thursday morning $46 per golfer ______ $0.00 ______ Event Total $0.00 ______ Grand Total Banquet Entree (Member): Flatiron Steak___ Pinenut Colorado Striped Bass___ Vegetarian___ Banquet Entree (Spouse/Guest): Flatiron Steak___ Pinenut Colorado Striped Bass___ Vegetarian___ Name of Member ______________________________________ Name of Spouse or Guest __________________________________ Cell _________________________ Cell _______________________ Address _______________________________________________________________________ City _______________________ State _____ Zip Code __________ Phone _________________ Email _________________________________________________________________________ Emergency Contact Name and Number _______________________________________________ Special Food/Transport Needs ______________________________________________________ Information about you/your family to be published in the Registration Book: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ NLT 15 April 2015, please mail this form and a check payable to “RAJA Inc.” to: Brian X. Bush, 18550 Augusta Drive, Monument, CO 80132. (Please see refund policy in meeting information.) NLT 1 May 2014, make a reservation at the Doubletree, Colorado Springs, 1755 E. Cheyenne Mountain Blvd., Colorado Springs, CO, phone 719-576-8900 - tell them you are with RAJA - $119 double; $109 single. *Golfers: Contact Brian Bush at [email protected] to indicate whether you need rental clubs (left or right - or for Don Curry - a set of ladies).
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