Please make all checks and
money orders payable to “EPC/Spirit
Awakening”
Please mail to:
Gabby York
308 Aladdin Ave
Alton, IL 62002
Registration: $25 Until January 31, $35 After January
31
$15 for children under 10
Guest
#_______
¯¯¯
For
office use only
Last Name
______________________ First Name_________________
Magickal
Name__________________ E-mail
__________________
Group/Coven
_____________________
Address____________________________
____________________________
____________________________
City ______________
State ______ ZIP _______
Emergency Contact
____________________
Number__________________
If child, guardian name
_____________________
Payment amt
$___________
Payment method check # ________ money order