LION ROARS - Lionel Collectors Club of America

Form may bephotocopiedLionel ® Collectors Club of America31st ANNUAL CONVENTION - REGISTRATION FORMPre-Registration Fee of $39 must be received on or before June 1, 2001.If received after June 1st or at the door, the Registration Fee will be $54.No refunds after July 15, 2001 — Please print or type.Name:_______________________________________________________________ LCCA#: __________________(First) (Middle Initial) (Last)Address:______________________________________________ Phone #:_________________________________City:_______________________________ State:________ Zip Code:_________ Are you a dealer? ___Yes ___NoSpouse’s name (if attending*):____________________________________________________________________(*If spouse is a Regular Member and wants the complete Convention Commemorative package, a separate, full registration fee must be paid.)CONVENTION REGISTRATIONChildren’s names and ages (if attending):____________________________________________________________If you want your table next to a specific member**, indicate:Member’s name:______________________________________________ LCCA#:___________________**Please send your form and the other Member’s form (with separate checks/money orders) in the same envelope.Member Pre-Registration (includes non-Member spouse and children)Tables — Each with one chairElectrical Hook-up — per registrantGet Acquainted Party _____ @ $14 (Adults) _____ @ $20 (Adults) _____ @ $8 (Children)(Hyatt Guests) (non-Hyatt Guests)__________@ $39 = $_________________________@ $25 = $_________________________@ $30 = $_______________YOU MUST INDICATE A MEAL SELECTION BELOWBanquet — Make your entree choice (includes salad, vegetable, coffee/tea/milk & dessert)= $_______________Adult: _____ 6 oz. Filet @ $39 -or- _____ Honey Bourbon Chicken __________@ $34 = $_______________Children: A menu specially designed for our younger guests __________@ $19 = $_______________Tours Selections — Enter the sub-total cost of the tour(s) selected on the work sheet here:List the tours by number and seats (e.g., Tour #1, 2 seats, etc.) below:$_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________GRAND TOTAL: $________________Make check/money order (in U.S. funds) payable to: 2001 LCCA Convention.To charge it to your credit card, fill out the information below.CARD # _________________________________________________ [ ] VISA [ ] MASTERCARD [ ] DISCOVEREXP. DATE ______________________ SIGNATURE ________________________________________________Send this form or a photocopy withDO NOT send hotel reservations to the LCCA.check/money order or credit card info to:Use the separate form to make your reservations at the2001 LCCA Convention Hyatt Regency Lexington and mail your request directlyP.O. Box 479to their address listed on the form.LaSalle, IL 61301-0479Arrival Date: _________ Departure Date: _________23The Lion Roars April, 2001