PRE-REGISTRATION FOR An Tir/West War, June 30 – July 4, 2011

PRE-REGISTRATION FOR
An Tir/West War, June 30 – July 4, 2011
Pre-registration forms must be postmarked by 05/15/2011
Autocrat: Mistress Attia Prima, mandy.grayson@gmail.com, 503-984-7277, no calls after 9 pm
Gate Steward: Dame Juliana van Aardenburg, julianavana@comcast.net, 503-363-7512, no calls after 9 pm
Site Fee:
“SCA Member” refers to those persons who have a verifiable paid SCA membership card or other proof of membership.
Adult event fee (age 18+) PRE-REG
Adult event fee (age 18+) AT GATE
Youth event fee (age 6 - 17)
Child event fee (below 6)
Family cap (does not include NMS)
Non-member surcharge (non-SCA members aged
18+)
$15 per person
$20 per person
$10 per person
$0 per person
$50 for family
$5 per person
Check your calculations carefully as any errors may cause a processing delay.
There is a $5.00 non-member surcharge for adults. If you do not provide a photocopy of your membership card with your
pre-registration, you are assumed to be a non-member and must pay the surcharge for your registration to be accepted.
Note: There is a family price cap of $50. Family cap does not include non-member surcharge. "Family" does not include
SCA households or roommates - you must be related mundanely. Common-law and same-sex spouses are considered
related. No more than two adults in a family group can qualify for the family cap price. All others of that family must be
related children under 18 years of age.
Make checks payable to SCA, Inc. – Kingdom of An Tir.
Return completed form, site fee and photocopy of your membership card, front and back, to:
An Tir/ West War Pre-Reg
Mieke Visser
2270 Red Oak Dr S
Salem OR 97302
Provide a self-addressed, stamped envelope or email address in order to receive a reservation confirmation.
Please bring your reservation confirmation to the event gate to speed your entry to the site.
You must provide the reservation confirmation at gate if you are taking someone else's place.
All non-members will be required to sign the “CONSENT TO PARTCIPATE AND RELEASE OF LIABILITY” form at
gate.
An adult must accompany all minors. Minors not accompanied by their parent or legal guardian will be required to have
medical authorization forms and comply with the rules as stated on the form or they will not be permitted on-site. Forms
can be found at http://www.antir.sca.org/Pubs/forms/.
Any registration cancellation must be received in writing (email or paper mail) by the Gate Steward by June 1, 2011.
Refunds given after event only.

Send in this whole page. Please keep the previous page for your use and information.
PRE-REGISTRATION FOR
An Tir/West War, June 30 – July 4, 2011
Pre-registration forms must be postmarked by 05/15/2011
Legal First Name
Legal Last Name
SCA Name MEMBER #
Mailing Address
Branch
City State Zip Code
Contact Phone
Email address
Adult (18 and above) $15.00 Minor (6-17) $10.00 Child under 6 FREE
ADULT NON-MEMBER SURCHARGE $5.00
Family members related to person above:
Legal First Name
Legal Last Name
SCA Name MEMBER #
Adult (18 and above) $15.00 Minor (6-17) $10.00 Child under 6 FREE
ADULT NON-MEMBER SURCHARGE $5.00
Legal First Name
Legal Last Name
SCA Name MEMBER #
Adult (18 and above) $15.00 Minor (6-17) $10.00 Child under 6 FREE
ADULT NON-MEMBER SURCHARGE $5.00
Legal First Name
Legal Last Name
SCA Name MEMBER #
Adult (18 and above) $15.00 Minor (6-17) $10.00 Child under 6 FREE
ADULT NON-MEMBER SURCHARGE $5.00
Legal First Name
Legal Last Name
SCA Name MEMBER #
Adult (18 and above) $15.00 Minor (6-17) $10.00 Child under 6 FREE
ADULT NON-MEMBER SURCHARGE $5.00
Total Site Fee enclosed: $_____________
Family cap is $50 (does not include NMS)
REMEMBER TO INCLUDE PHOTOCOPIES OF MEMBERSHIP CARDS, FRONT AND BACK.