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Registration Form

Print out and mail to :

The Prosperos IOC
Attn : Assembly 2007
P.O. Box 4969
Culver City CA 90231

Full Name :	_________________________________________
Address 1 :	_________________________________________
Address 2 :	_________________________________________
Address 3:	_________________________________________
City, State, Zip :	_________________________________________
Telephone :	_________________________________________
Email address :	_________________________________________
Comments or special concerns :	_________________________________________
	_________________________________________
	_________________________________________

Please check one : _____ I will stay at the Buckhorn Springs| _____ I will stay off-site

I am enclosing :

____ Balance on-site room fee (due by August 25, 2007)

____ Full payment on-site room fee (see Fees page, due by August 25)

____ Full payment for Assembly only, $195; I will stay off-site.

____ Other : ______________________________________________

The Buckhorn Springs Resort will assess extra charges for single occupancy.

Use the link below to send your payment via PayPal.

Thank you for your support of The Prosperos !

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For reservations and information, contact or call Carol Chappell at 541-535-2817.