Early Registration Form

Rails Of Ages
Early Registration Form
April 28^th - May 1^st 2011

Sponsored by
NMRA, Mid Central Region, Division 5
The Western Reserve Division

Primary registrant MUST be an NMRA member at time of Convention
(see fee for joining if you are not a member)

Primary Registrant Badge Name

NMRA No. Region Division

Address City St/Prv Zip

Phone Email

Number of
Persons Attending

Names of others

Item	Quantity	Price	Amount
Early Basic Registration (through Jan 31, 2011)	1		0.00
One Year Full NMRA Membership (only needed if you are not currently an NMRA member Special Discount of $15 provided by Division 5)			0.00
Family Members (Same Household)			0.00
		Total	0.00

Note: Sign-up form for special activities, tours, and extra fare items will be sent out to all early registrants at a later date. Activity assignment will be based on the order that the registrations are received. Submitting via this website, requires that you to send your payment to us within 10 days, or your registration will be void.

Make check payable to: NMRA MCR Division 5

Mail to: Convention Registrar, Dennis Lloyd
75 Newell Street Painesville OH 44077

Phone: (440) 352-7081

Email: Registrar@RailsOfAges.org

Room reservations should be made directly with the convention hotel
The Lodge & Conference Center at Geneva-on-the-Lake
4888 North Broadway Geneva-on-the-Lake, Ohio 44041
Phone: (866) 806-8066 www.TheLodgeAtGeneva.com
Rate is $95 per room plus applicable taxes. Reserve under ID 4G35KW

Rev 12/07/2009

Important: Before submitting this registration, you should printout this completed form as your copy.