Registration

Important, please note: Our privacy policy is simple - we will never sell, display, or show your personal information to any third party without your prior and explicit approval. By giving us your e-mail address you are consenting to receive occasional e-mail announcements from Capricon and Phandemonium. You may request your e-mail to be removed from our distribution list at any time.

Capricon uses PayPal to accept on-line registration payment via credit cards or direct funds transfers. No payment will be authorized until you have finished the pre-registration process and have reviewed and confirmed the information. Advance registration price is currently $70 charge per person. Kids-in-tow (children under the age of 12 that are with a parent at all times) are free.

Please fill in the following information for the primary registrant and up to ten additional people. All people must live at the same address. If you need to register more than ten people, please break them up into groups of ten or fewer. The fields marked with an asterisk (*) are mandatory. Additional registrants after the primary need only fill in a name and badge name.

WARNING: This form works best with Javascript. If you do not have Javascript turned on, your registration may not be saved. Please complete the pdf form and mail it in with your payment if you do not wish to turn Javascript on.

First Name:		Last Name:	*
Address 1:	*
Address 2:
City:	*	State:	AK - Alaska AL - Alabama AR - Arkansas AZ - Arizona CA - California CO - Colorado CT - Connecticut DC - District Of Columbia DE - Delaware FL - Florida GA - Georgia HI - Hawaii IA - Iowa ID - Idaho IL - Illinois IN - Indiana KS - Kansas KY - Kentucky LA - Louisiana MA - Massachusetts MD - Maryland ME - Maine MI - Michigan MN - Minnesota MO - Missouri MS - Mississippi MT - Montana NC - North Carolina ND - North Dakota NE - Nebraska NH - New Hampshire NJ - New Jersey NM - New Mexico NV - Nevada NY - New York OH - Ohio OK - Oklahoma OR - Oregon PA - Pennsylvania RI - Rhode Island SC - South Carolina SD - South Dakota TN - Tennessee TX - Texas UT - Utah VA - Virginia VT - Vermont WA - Washington WI - Wisconsin WV - West Virgina WY - Wyoming *
Zip Code:	*	Phone Number:
	Please do not contact me by mail.
	Please do not contact me by phone.
Badge Name:	*
E-mail Address:	*
	E-mail is required for payment by PayPal.
	Please do not contact me by e-mail.
Please Contact me about:
Advertising		Anime
Art Show		Dealers
Events		Films
Gaming		Parties
Programming		Volunteering
Secondary Registration
Select Number of Other Registrations		0 1 2 3 4 5 6 7 8 9 10
*Note: Kids in Tow badges will not be pre-printed. Please come to the main Registration desk to get a badge. We ask that Kid in Tow badges be requested in advance so that we have an idea of how many children will be attending the convention.
Select Number of Kids in Tow		0 1 2 3 4 5 6 7 8 9 10