: Group Overnight - Event Registration

Group Overnight

INFO:

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Registrant Fee:		$0.00
Group Fee:		$0.00
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Billing information

First Name

Last Name

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Address

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Billing and Payment
Billing and payment processing for Businesses' events is performed by Member Solutions, Inc. ("MSI"), and this contract is specifically assigned to MSI for all such purposes. Customer knowingly and irrevocably authorizes MSI to charge electronically Customer's bank account and/or credit card for any and all amounts due for Customer's, and anyone registering under Customer's, attendance and participation in the Event. Please note, you may see all or any portion of the following on your bank or credit card statement: "MSI*EDGERTONEXPLORITCENT 8882448044 ONLINE REG FEE". Any returned payment will be assessed a $25.00 fee. Any unsuccessful electronic transaction is subject to a $10.00 processing fee. MSI is not responsible for any bank fees incurred by Customer. MSI has the sole right to resubmit returned or declined items (plus applicable fees) without prior notice. BILLING INQUIRIES -- 888-244-8044 or by mail to PO Box 297, Hatboro, PA 19040.

Applicant Agreement
I represent that I am the person who appears on the application above. I acknowledge and agree to the statements, terms and conditions above, as well as any applicable terms and conditions for this registration, and that by typing my name below and completing this registration form, I am electronically signing the document, which will have the same legal effect as the execution of the document by a written signature and shall be valid evidence of my intent and agreement to be bound.

Applicant Signature
Please enter your full name in the space below.

Please click the button below to finalize your registration.

Registration inquiries:
Mary Molliconi
mary@edgerton.org
(402) 694-4032
208 16th St
Aurora, NE
68818 USA

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Registrant

use this registrant for billing information

Primary Contact Information

Contact First Name

Contact Last Name

Address

City

State

Zip

Phone

Mobile Phone

Group Name/ Kind

Programming Information

Number of Youth Participants

Age Range of Students

Total number with adults

Preferred Date

2nd preference for Date

All Overnights start at 7pm and run through 9am the following morning.

Demonstration Options

If you would like more than 2 demonstrations there is a per-person additional fee for each added demonstration

Student Labs

Pricing Information

Pricing is $500 per group, of up to 20 people. Each additional person (after 20) is $25 each.

This registration requires a $250 non-refundable deposit. With full payment being received a week before the event. You may set the payment schedule below or pay in full at this time.

Do you have more than 20 participants?

How many additional participants wiill you have?

limited quantity available: 30 remaining

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