Registration Addendum & Payment
Authorization
April 10-12, 2015
Galveston, Texas
Use this form to order additional registration for attendees and or Child Care options.
To discuss opportunities, please contact Stephen Mabry at [email protected] at (830) 896-8500.
CONTACT INFORMATION:
________________________________________________________________________________________________
Contact Name – (Initial Registrant in system)
________________________________________________________________________________________________
Address
________________________________________________________________________________________________
Street
City
State
Zip Code
________________________________________________________________________________________________
Phone
Mobile
Fax
________________________________________________________________________________________________
E-mail
Cost recap: Conference Fee for all additional guests is $50.00 each. Kidz Kamp (ages 5-12) is $50.00 each and Kidz Care
(ages 1-4) is $35.00 each. (Additional Information on reverse side.) Tracts: choose from the following:
Grandparents/caregivers, Adults/Parents, KidzKamp, KidzCare.
Tickets:
1.___________________________Tract: ______________________________
2.___________________________Tract: ______________________________
3.___________________________Tract: ______________________________
4.___________________________Tract: ______________________________
5.___________________________Tract: ______________________________
6.___________________________Tract: ______________________________
Cost: ___________
Cost: ___________
Cost: ___________
Cost: ___________
Cost: ___________
Cost: ___________
Total: _________________
PAYMENT METHOD : I wish to purchase additional tickets to add to my initial registration, and agree to pay the above
listed charges.
 Bill the following credit card:
Credit card type: VISA ______ MASTERCARD ______ DISCOVER_______
Name as it appears on card ___________________________________________________
Credit Card Number: _____________________________________________Exp____/____
CVV________
Authorized Signature_________________________________________________________ Date:___________________
Please return completed form to:
Texas Lions Camp, Inc. | PO Box 290247 | Kerrville, TX 78029
Phone: (830)896-8500 • Fax: (830)896-3666 • Email: [email protected]
Federal Tax ID# 74-1189679
Kidz Kamp at Moody Gardens .......................................................................................... $50.00 + Conference Fee
The Kidz Kamp program will be held 8:00-5:00 pm on Saturday and is geared for children ages 5-12. Children
attending this program will also need to purchase a conference badge since meals on Friday, Saturday and Sunday
are also included.
Children will be treated to a number of Moody Garden’s unique venue and programs, such as:
- The Rainforest Pyramid and themed presentation
- Aquarium Pyramid and Ocean themed presentation
- Activities, games and crafts related to these themes
- A MG3D Theatre movie
- and meals
Kidz Care......................................................................................................................................... $35.00 per day
Kidz care (day care for children ages 1-4) will be available on Saturday 8:00 – 5:00 and Sunday morning 8:30-11:30
AM on the Moody Gardens premises. Children will be supervised and be treated to their own brand of Moody
Gardens fun.