Please print this page. Fill out one registration form per person, including children (photocopy as needed.)
Make checks payable in U.S. dollars to: WMADI. Mail to: WMADI, 9609 Pinkney Ct., Potomac, MD 20854.

Name: __________________________________________________________ circle one: Male Female Age (if under 18) ____

Amount enclosed for this registration $________ Tax deductible donation $_________

Address: ________________________________________________________________________________________


Home phone _________________________________ Work Phone _________________________________________

Email _____________________________________(if no email, please provide a SASE, so we can confirm your registration)

I might want a size _______t shirt if you have them for sale (no commitments)

I plan to stay in a tent yes ______ no _______ (Cabin space will be assigned for toilet facilities.)

Cabins: men only _______ women only _______ coed _______ family w/kids _______

Names of people I plan to room with ___________________________________________________________________

I plan to eat vegetarian ____ vegan ____ omnivore ____ (please check one)

Other special eating or sleeping requirements (food allergies, CPAP, snorer___________________________________________________________

I need a ride _____ I’m willing to give a ride and have room for ______ riders