Fill out the entire form, then PRINT the form. Your registration will not be processed until your payment (check or money order only, please, or click the link below to pay via PayPal or secure Credit Card) and signed registration form are received in the mail.  Please fill in ALL fields. Each person attending must fill out a form and the registration fee is per person. Amounts may be combined into one total. An email confirmation will be sent to you after receipt of payment.    Thanks.      See you in Hot Springs !

Please make your payment payable to:   Weekend at Bernie's   and mail to:   Weekend @ Bernie's
                                                                                                                  Attention: Bernie Attema
                                                                                                                  PO Box 133
                                                                                                                  Hinton, IA 51024

Click HERE if you want to register and pay online via PayPal or secure Credit Card

First Name: Last Name:
Address: City:
State: Zip:
Phone: e-mail:
 
 Weekend @ Bernie's, $30.00
(On-site registration is $35.00)
 
 MINOR (under 18 years old), Weekend @ Bernie's, $20.00
(A parent or legal guardian MUST sign an insurance release form at the event)
 
 Weekend @ Bernie's 2006 T-Shirt ,  $15.00 each    (On-site will be $20.00 each, limited quantity)
Enter Qty:   S    M    L    XL    XXL    3XL    4XL
 
 Weekend @ Bernie's 2006 Patch $6.00   
 
 Weekend @ Bernie's 2006 Pin  $5.00   
 2005 Weekend @ Bernie's T-Shirt ,  $12.00 each
Enter Qty:   L    XL    XXL
Total of all items checked above: $enclosed

Click HERE if you want to register and pay online via PayPal or secure Credit Card

Note, pre-ordered T-shirts will be ready at Registration in Hot Springs

Please remember to print the form and mail it with your payment Click HERE if you want to email Bernie