Balticon 49 Registration Form - Mail-in Registration deadline is May 4, 2015.
Name: ___________________________________________ Adult Child (circle one)
Badge Name: ___________________________________
Name: ___________________________________________ Adult Child (circle one)
Badge Name: ___________________________________
Name: ___________________________________________ Adult Child (circle one)
Badge Name: ___________________________________
Name: ___________________________________________ Adult Child (circle one)
Badge Name: ___________________________________
Address: _________________________________________________
_________________________________________________
City:________________________ State:______ ZIP:________ Country:_______________
e-mail:__________________________________________ Phone: ( )________________
(Please copy this page for additional registrations. One address per form, please.)
If postmarked by: 02/28/15 04/15/15 After/At door Quantity Total
Adult $55 $60 $65 x ____ $_________
Child (age 6-12) $27 $30 $33 x ____ $_________
Balticon 48 (2014) 3-DVD set, including Masquerade, Special Events and select
Film Festival entries $30 (includes tax & shipping)
x ____ $_________
Tax deductable donation to BSFS to support Literary Projects ----> $_________
Total $_________
Payment Options:
[ ] Check/Money Order payable to Balticon [ ] Mastercard [ ] Visa
Card Number: ___________________________________ Exp (Month/Year) _______
Signature of Cardholder: x_________________________________________________
Cardholder name as it appears on the card: ____________________________________________
Card Billing Address: __________________________________________________________________
City: __________________________ State: _____ ZIP: _______ Country: ____________________
Send this form and payment to: Balticon 49 Registration
P.O. Box 686
Baltimore, MD 21203-0686
Notes: Children under 6 are free if accompanied by an adult at ALL times.
For more information, check your areas of interest below.
[ ] Handicapped access [ ] Party Registration [ ] Young Writer's Contest
[ ] Open Staff Positions [ ] Artist Registration [ ] Writer's Workshop
[ ] Artist Alley [ ] Masquerade [ ] Film Festival
[ ] BSFS Books for Kids [ ] Volunteering [ ] Costuming Track/Wrkshop
[ ] Fan Tables [ ] Poetry Track/Workshop [ ] Becoming a Program Participant
[ ] Sponsorship [ ] BSFan Advertising Other: _____________________________
Balticon is a service mark of the Baltimore Science Fiction Society, Inc.,
a 501(c)(3) non-profit educational organization.
Balticon 49 Home Page Go to the BSFS Home Page.