Registration First name ___________ ___________ ___________ ___________ Last name _______________ _______________ _______________ _______________ Child’s birth date __________ __________ __________ __________ Street _____________________________ City, State & Zip _______________________ ❏ Check if address information has changed. Please put additional addresses, phones, etc. on back. T-Shirt S—XL $12 each, (2X—3X $13) Colors: Black, Forest Green, Indigo, Rust Children’s T S (6-8), M (10-12), L (14-16) $12 each Colors: Forest Green, Rust Women’s T-Shirt Capped Shleves, Slight Scooped Neck, Sizes run slightly small Women’s sizing S—XL $12 each Colors: Black, Chocolate, Navy Tote Bags $14 each, Black Design will look good on Black Big nice size, 20” x 15” x 5” Home phone _____________________________ Work phone ______________________________ E-mail _________________________________ Please note if you prefer that any of these NOT be printed on the Moon Festival participants contact list. Workshops We would like to offer (adult workshops): _____________ ________________________________________ ________________________________________ We would like to see offered (and by whom): __________ ________________________________________ We’ll offer the following REQUIRED Kids’ Co-op workshop: ________________________________________________ First Aid List Willing to help? Please identify yourself. __ Doctor __ Nurse __ EMT __First-aid Kit Mail To: Moon Festival - c/o Chuck Palmer 2270 Bluebell Ave - Boulder, CO 80302 Item         ______ ______ ______ ______ Color _______ _______ _______ _______ Size ____ ____ ____ ____ Qty. ____ ____ ____ ____ Price x Qty $ _______ $ _______ $ _______ $ _______ People Adults Adults (after Sept 5th) Kids (4-15) Tots (0-3) Total __ @ $90 __ @ $100 __ @ $40 __ free = $_______ = $_______ = $_______ = $_______ Make check payable to: Moon Festival