NICON 2010 Registration Form

Competition                Please tick box for selection             þ                                     

15mm FOG	q	25mm DBMM	q
Games Workshop – Warhammer 40K	q	Warhammer Fantasy Battle	q
Napoleonics	q	WRG Micro moderns	q
Flames of War	q	Early War q Mid War q Late War q
Lord of the Rings	q	War of the Ring	q
25mm DBR	q	Other – Please state in space below	q
Dinner   Single q Double q	q	:-
If unsuccessful please state second choice	?	:-

Payment          Please tick box for method of payment             þ 

Tournament Registration rates :- Standard entry  $40.00  by 07/05/10,  Late entry  $55.00 by 28/05/10.

Any entries after 28/05/10 are at the digression of the organizers and umpires.

The price for dinner is $25.00 per head

Please make Direct credit payments into our bank account number 03 0435 0465202 000      q

Please include name and competition as reference

Please make cheques out to Tauranga Tabletop Gaming Club.                                        q

__________________________________________________________                   (Signature)

If under 16 years of age please provide parent/guardian's signiture and contact details if different to above.