May 19-21, 2013 Atlantis Casino Resort Spa, 3800 S. Virginia, Reno nv event Registration

Name_________________________________________________________________________

Spouse Name__________________________________________________________________

Address_______________________________________________________________________

City, State, Zip_________________________________________________________________

Phone, Email__________________________________________________________________

Attendee Type (please circle one): Team Member Type 1 Team Member Type 2

Spouse Other

Please send both the registration form and fee no later than April 25, 2012 to:

Jim Hanrahan, 4090 Cheryl Drive, Redding CA 96002

Make checks or money orders payable to Jim Hanrahan. Amount enclosed $______________

You must make separate room reservations by April 15, 2013 at the Atlantis Casino Resort Spa at 1.800.723.6500 or 775.825.4700. The special rate is $89.00 per night if reserved before the deadline.

I am interested in attending these outside activities for an additional cost (please check all that apply);

_____Golf Tournament _____Virginia City Day Trip _____Trap and Skeet Shoot

Will you have a display to set up? What type? Vendor_____ Team_____ Fire History/Memorabilia____

Please fill out the names of any team members who have passed away so they may be honored at the dinner banquet:

_____________________________________________________________________________________