Event Registration <-- return to event Event Name Event Date Begin Time 12:00 AM12:30 AM1:00 AM1:30 AM2:00 AM2:30 AM3:00 AM3:30 AM4:00 AM4:30 AM5:00 AM5:30 AM6:00 AM6:30 AM7:00 AM7:30 AM8:00 AM8:30 AM9:00 AM9:30 AM10:00 AM10:30 AM11:00 AM11:30 AM12:00 PM12:30 PM1:00 PM1:30 PM2:00 PM2:30 PM3:00 PM3:30 PM4:00 PM4:30 PM5:00 PM5:30 PM6:00 PM6:30 PM7:00 PM7:30 PM8:00 PM8:30 PM9:00 PM9:30 PM10:00 PM10:30 PM11:00 PM11:30 PM End Time 12:00 AM12:30 AM1:00 AM1:30 AM2:00 AM2:30 AM3:00 AM3:30 AM4:00 AM4:30 AM5:00 AM5:30 AM6:00 AM6:30 AM7:00 AM7:30 AM8:00 AM8:30 AM9:00 AM9:30 AM10:00 AM10:30 AM11:00 AM11:30 AM12:00 PM12:30 PM1:00 PM1:30 PM2:00 PM2:30 PM3:00 PM3:30 PM4:00 PM4:30 PM5:00 PM5:30 PM6:00 PM6:30 PM7:00 PM7:30 PM8:00 PM8:30 PM9:00 PM9:30 PM10:00 PM10:30 PM11:00 PM11:30 PM I am a member of NWC Yes No Name * First Name Last Name Last Name Email Address * Phone Number Per MemberCharge Per GuestCharge Number of Guests(besides yourself) Leave blank if you are not bringing a guest. Member MealChoice * -Select Meal- Check if No Member Meal Yes Guest #1 Name Guest #1 Meal Choice * -Select Meal- Guest #2 Name Guest #2 Meal Choice * -Select Meal- Guest #3 Name Guest #3 Meal Choice * -Select Meal- Guest #4 Name Guest #4 Meal Choice * -Select Meal- Guest #5 Name Guest #5 Meal Choice * -Select Meal- Guest #6 Name Guest #6 Meal Choice * -Select Meal- Guest #7 Name Guest #7 Meal Choice * -Select Meal- Total Event Cost Credit Card Information * Address * Address Address Address City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal If you are human, leave this field blank.