Name (First and Last):  
           
        
          Screen Name/Nickname:  
           
        
          Age:  
           
        
          Email:  
           
        
          Address:  
           
        
          City:  
           
        
          State:  
           
        
          Zip:  
           
        
          Phone:  
           
        
          Attending With* :  
           
        
          *  - If this registration is for an 
            ADULT  accompanying a CHILD  under the age of 18, include the 
            child's name here. If this registration is for a CHILD  under 
            the age of eighteen, include the name of the accompanying ADULT  
          here.  Include multiple names if applicable.
 
        
          How did you hear about us?: 
            
 
        
          Please specify:
 
        
          Choose Admission Type: 
            
 
        
          
  *  - Walk-Ins will be $12 at the door Saturday.
			(Admission includes Dairycon 15th Anniversary poster, commemorative schedule, raffle ticket, and attendee badge.)
 
        
          Dealer Table Purchase: 
 
          Note:  Dealers, if you want more than the standard attendee packet, you MUST 
Dealer Tables: $20 Each (Includes show admission for one dealer only, not one per table .)
            How many tables do you need? (Maximum 2) 
			Note on Dealer Helpers:  Dealer Helpers must register separately and should select a Regular Attendee Admission. List any Dealer Helpers below. If not registered and listed below, they will not be allowed in during dealer setup and would have to pay as a walk-in ($12).
			Dealer Helper Names: 
          
		  Registration Add Ons: 
  
          
			*SOLD OUT* only  at Dairycon!)
			15th Anniversary Exclusive Figure #2! $199 (Includes figure, bio card, special convention packaging, and other pack-ins! Cannot be ordered; can only be won at Dairycon! 
			 *  - Cannot be ordered; can only be won at the Ultimate Prize Giveaway.
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   			*SOLD OUT* 
   			*SOLD OUT* 
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   			* 
   			* 
   			* 
   			* 
			*  - These Dairycon Exclusive Kits Cannot Be Purchased! You can only get them by winning them at the Show! Available only  at Dairycon! 
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			Specify size(s): 
			Note:  Dairycon T-Shirt comes in sizes L, XL, 2XL. Other sizes require an additional charge. Please contact us for details.
		  
 
        
          
		  Contests and Special Events: 
  
          here !
          
			Important Notes (Please Read): 
  
          			
			Preregistration closes March 1st, 2015, so hurry! 
            You may receive a paypal invoice for your dealer tables, exclusive items, and t-shirts. More... 
			Please Note: When you Preregister, you will receive a confirmation e-mail from us within 7 business days, so you know your Pre-reg has been received. You will receive a full confirmation packet once preregistration closes. Exclusions... 
            For a detailed explanation of scheduled Dairycon Events, Click Here !
			For directions to Dairycon, Click Here !
			For a map of the dealer room, including our new Crystal Ball Room location, Click Here !
			
 
        
          
			Please add any additional comments you have below: