A Magical Weekend

Palmerston North Magic Circle Convention

24-26th October 2009
Magician’s Registration Form Adult (16yrs+) Junior (<16yrs)

Name __________________________ Preferred first name _______________

Name for Badge ___________________
Address ______________________________________
______________________________________
Contact Phone number(s) Hm __________________ Mobile _______________________
Email ____________________________
Magicians’ registration includes 1 complimentary Gala show ticket for the 2pm show, morning & afternoon teas.
Please note: Lunches and evening meals (including the Convention Banquet are not included).

Guest registration (Spouse/partner/children)

Name(s)_____________________________ _____________________________
_____________________ _____________________
Guest registration includes morning and afternoon teas.
Please note: Guest Registration does not include Gala Show tickets. Please indicate number of Gala Show tickets required
for your guest(s), (Adults $20, Children $10) in the payment section of this form. Tickets will be allocated for the first
show, subject to availability.

Registration fees
Please note: All registrations fees are required to be paid in full at the time of registration.

Number Total $
Magician Adult $65, Junior $50 1
Guest(s) @ $25 each
Additional Gala Show Tickets
Adults @ $20
Children @ $10
TOTAL PAYMENT BY CHEQUE INCLUDED $
Date payment made:
OR Payment made by Internet banking: $
Please make cheques payable to “PNMC 09 Convention”
Details for internet banking: ANZ bank: Payee Name: PNMC 09 CONVENTION
Account Number: 11 6900 0023950 12
Please put your first initial and as much of your surname as possible in the “particulars” for our
statement, (Eg RLucas for Robin Lucas)

Send this form and all Correspondence to:

R.Lucas, PNMC Hon Secretary, 35 Langley Ave, Palmerston North, 4414. Email: pn09convention@hotmail.com