LBA Registration ~ Step 2: Paypal

This is the Online LBA Registration Form (using PayPal).

The next page will be payment page. LBA price is $90 per person, plus optional items.

Please type your name as you would like it to appear on your event credentials.

* (asterisk = required information)

The Usual Information

First Name*

Last Name*

e-mail address*

e-mail address again*

2nd Guest ~ First Name (if registering as a couple)

2nd Guest ~ Last Name (if registering as a couple)

Street Address*

City*

State:*

WA AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WV WI WY VI - Virgin Islands AB - Canada BC - Canada MB - Canada NB - Canada NL - Canada NS - Canada NT - Canada NU - Canada ON - Canada PE - Canada QC - Canada SK - Canada YT - Canada MX - Mexico ?? - OTHER

Zip Code*

Phone Number (including area code)*

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Fun Stuff

1st Guest: Nickname (for your badge/credentials) (optional)

2nd Guest: Nickname (if registering as a couple) (for your badge/credentials) (optional)

Parrot Head Club Affiliation, if any (optional) (no Initials, full names please)

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The limo service is now fully booked. Please make alternate arrangements for your travel to LBA.

I/we are arriving at SeaTac Int’l Airport and would like to be contacted about complimentary limousine service from and to the airport.

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T-Shirt Option

1st Guest: Do you want a T-shirt?*

No
Small $18
Medium $18
Large $18
XLarge $18
2XL $22
3XL $22

If you are not registering a second guest, please select "No" for this entry.

2nd Guest: Do you want a T-shirt?*

No
Small $18
Medium $18
Large $18
XLarge $18
2XL $22
3XL $22

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LBA Volunteer Opportunities (Optional)

1st Guest: I would like to volunteer for:

Goody Bag Stuffing
Registration
Decorating
Auction/Raffle/Ticket Sales
Merchandise Sales

2nd Guest: I would like to volunteer for:

Goody Bag Stuffing
Registration
Decorating
Auction/Raffle/Ticket Sales
Merchandise Sales

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The Fine Print
I am sending my registration information electronically and payment via PayPal. I understand that my registration is not complete until my payment has been completed.

PayPal Agreement*

By checking this box, I understand that registration fees are not transferable. There are no refunds. If I cannot attend, my fees will go toward selected Laid Back Attack charities.

I Agree*

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CAPTCHA Code:*

Please only click the “Submit” button once. Thank you.

 VERY IMPORTANT!!!: Please be sure to complete ALL the remaining registration steps for LBA !!!

Optional fun activities will be announced before the start of LBA.
There will be separate sign-ups at the event.