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Return to Bears In
the Heat main page.
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Return to Main Page.
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First Name
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Last Name
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Address:
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Apt, Ste, Lot, etc.
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Please NOTE!
Use your TAB KEY or
MOUSE to move from box
to box!
Do not press your ENTER
key after putting
information in a text box.
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City:
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State
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ZIP
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Area
Code
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Cell Phone Number
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Name Badge Name or Internet Nick:
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EMail:
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Club Affiliation/Office
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Is photography ok?
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Dietary Restrictions.
If you have dietary restrictions which would require optional meal choices please indicate below. And we
will do our best to accommodate your needs.
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Dietary Restrictions:
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Registration Fees
Registration Fee, 2011, $65. After July 1 & Walk-Ins = $85.
Registration Fee Includes:
(Friday: Dinner, 50/50 split Poker Run & Bus transportation for Poker Run)
(Saturday: Teddy Bear Picnic, Dinner and Entertainment
**NOTE: Registration Fees Received After July 1--bus transportation cannot be guaranteed,
will be on availability basis only.
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Registration
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For our planning purpose, please indicate your arrival date. Also, if you need
transportation to and/or from the airport, please indicate that by checking the check box.
We will make transportation arrangements via e-mail as time gets closer to the run.
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Check here if you need
airport transportation.
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Arrival Date
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CANCELLATIONS: If you are unable to attend, you must cancel your reservation in writing. Cancellations postmarked by June 30 will
receive a refund minus a $10 refund fee. Cancellations after June 30 will be handled on a case-by-case basis. NO SHOWS will not
receive a refund, but will receive by mail their registration packet and shirt, four to six weeks after the event.
RELEASE: At check-in you will be required to sign a release that states the following:
I certify that I am at least 21 years of age. I agree to the rules of the outing; to hold harmless and blameless the Wichita Bears, its
members, guests, and representatives for any personal injury and/or loss of property; and to assume all responsibility for the same during
Bears In the Heat. I also understand that photographs and video may be taken. If you DO NOT wish to have your photographs taken
please check the box above. Name tags will indicate photography preference.
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For ON-LINE REGISTRATION: Click the "Submit" tab to register. Select the "Reset" tab
to clear all information. Click on the "PayPal" link to pay your registration fee.
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OFF-LINE REGISTRATION
Complete registration form, print the form. To send completed form and check or money order
contact Jeff Anschutz, Treasurer at freebear62@yahoo.com .
Click here to retrieve OFF LINE REGISTRATION FORM IN PDF AND PRINT
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