2006 ANNUAL MEMBERSHIP
ONLINE REGISTRATION



All four Events for $140.00 (including the DEXCON 9 Wednesday Night Buffet)
PLUS $5.00 off all other 2006 DE Events!

You may register for the Double Exposure 2006 Annual Membership until Friday, January 13, 2006 (at midnight). Please use the following form to register. You will be sent a confirmation eMail within 24 hours. Your $140 Annual Membership gives you Complete Memberships at DREAMATION 2006, Spring Gathering 2006, DEXCON 9/INTERCON NORTHEAST (INCLUDING the Wednesday Night Buffet!) and Southern Exposure III, PLUS $5.00 off ALL 2006 smaller Double Exposure events!

If you are using a credit card, you will have the opportunity to enter the credit card using our Secure Server after you have completed the registration process. Each individual should fill out the information on this page separately, even if one credit card is paying for multiple people. Use the "Notes" field to explain what is being paid for. If you have already registered for the 2006 Annual Membership but are returning here to take care of your credit card payment for any reason (i.e. it got declined yesterday and you fixed it today), you can go straight to the payment page by clicking here.

Name:
eMail:
Street Address:
City:
State:
Zip Code:
Phone (daytime):
Phone (after 6PM):

SPECIAL DISCOUNT CODE Some groups have been given special codes which result in a discount on their individual 2006 Annual Memberships. If you are in such a group, please enter the code here and then adjust the amount you are paying appropriately.
Discount: $

Have you ever been to a Double Exposure event before?
Yes
No

Please choose a method of payment:

Credit Card via Secure Server: Once you submit this completed page, you will be given the opportunity to enter your credit card information on our Secure Server. Please note that it is YOUR responsibility to enter the correct amount to be charged AND to explain in the "Notes" field below if there is any discrepancy between the credit card authorization and the person who is actually registering (i.e. Jane Doe is paying for her son, John Doe).
Check: Once your form is accepted, we will give you instructions on where to send the check. Please note that unlike the credit card method, you will NOT be considered registered for the 2006 Annual Membership until your check clears.

Notes (please use this field to enter Discount Codes or any other information which deviates from the norm):
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