2015 Bootleg Star Party Registration Form
Star Party Dates: May 15th-17th
Pre-registration deadline is Saturday, May 9th. All forms must be postmarked no later than
May 9th to qualify for early registration. Each person registered will receive 1 door prize ticket.
Raffle drawing will be held Saturday at sundown. (You must be present to win)
$25.00 pre-registration / $40.00 at the door
(There is a $40.00 fee for all NSF checks)
Same registration fee regardless of the # of days
T-Shirts available - $17.00 ea. pre-order
Be sure to provide your e-mail address and phone number so we can contact you if there is a
problem with your form. Please print clearly (especially your e-mail address) We do not
share or distribute any of your personal information!!
Name: ______________________________________________________________________________________
Address: __________________________________________________________________________________
City: _____________________________
State: _________________ Zip: _______________________
Phone #: ______________________ Email: _________________________________________________
Number of People attending: _________ X $25.00 = _________________________________
Names of other people attending on this form: __________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
Number of T-Shirts requested: _________ X $17.00 = _______________________________
T-Shirt size(s): S M L XL XXL
Total Enclosed: _______________________________
Make your check payable to “Bootleg Astronomy” (there is a $40.00 NSF fee)
Mail this form to:
Bootleg Astronomy
P. O. Box 154
Lee, IL 60530
Questions? Contact Paul Jhona – [email protected]
Scott Foster – [email protected]
Evening phone # 1-815-762-7152
Do not mail this registration form by any postal method that requires a signature.
Bootleg Astronomers reserve the right to refuse any registration.
2015 bootleg_reg_form_v.2