redwood coast roundup logo Redwood Coast Roundup
"Stepping Stones to Recovery"
August 31, September 1 and 2, 2012 - Fortuna, Ca
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This is the registration form as of November 2011 - the 2012 registration form should be finalized no later than May 2012

 item price

quantity

item total

 Early Registration*
 (before August 20)

$15.00

   
 Sponsor a Newcomer $15.00    
 Registration
 (after August 20)

$20.00

   
 Saturday Lunch*
 (served by Al-Anon)

$10.00

   
 Saturday Banquet:  Tri-Tip or Lasagna, Vegetarian selction available.*
 (please circle choice or write in quantity column)
$20.00    
 Sunday Full Breakfast* $10.00    
 Coffee Mug $8.00    
 T-shirt: S, M, L, XL, XXL
 (please circle choice or write in quantity column)
$15.00     
all items total:  
*Pre-Registration is Recommended! (The number of meals is limited.)

  For the person filling out this form (in case we need to contact you):
 name
 phone
 email
 address
 city  state  zip

For name tags (first name and last initial, and please mark aa or al-anon):
name aa al-anon
     
     
     
     
     

Please include check or money order and send to:
Redwood Coast Roundup
P.O. Box 6943
Eureka, Ca 95502

You can register as AA or Al-Anon, sponsor a newcomer, pay less for early registration, buy Saturday lunch, Saturday dinner, Sunday breakfast, mugs, and t-shirts.  

Pre-Registration is recommended, since our meal tickets tend to sell out fast.  


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