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Virginia Living Museum
Fly Tying and Casting Registration
March 19, 2011


Time: 9:30am - 4pm
Age: 17+ (12-16 with an adult)
Cost: $40 Members; $50 Non-Members


 

 

I am a VLM Member
Members: Please complete the section below.
Non-Members: Please continue to next section to register.
Total Registering: If more than 3, please submit another registration.
1st Attendee Name:
DOB if under 18:

2nd Attendee Name:
DOB if under 18:

3rd Attendee Name:
DOB if under 18:
I am NOT a VLM Member
Non-Members: Please complete the section below.
Members: Please complete the above section to register.
Total Registering: If more than 3, please submit another registration.
1st Attendee Name:
DOB if under 18:

2nd Attendee Name:
DOB if under 18:

3rd Attendee Name:
DOB if under 18:
*Address:  
*City:  
*State  
*Zip:  
*Daytime Phone:  
*E-mail Address:  
Do any registrants have medical conditions?
If yes, please list registrant and condition:
Special Requests or Comments:
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