Mudhole sponsored CRBG Workshop 25

January 25 & 26, 2025

First Name

Last Name

Member #

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Email

example@example.com

Please select all applicable questions

I will bring a rod for displayI will bring a rod for the People's Choice AwardI will bring an item to be raffledI will purchase raffle tickets at the workshopI am willing to provide support where needed for the workshopI would like to make a presentation at the WorkshopI request hotel information

Fees: Only active members may participate in this event; if you are new or need to renew, please check the below listing for membership fee.

A special, Limited Activity Membership is now available for participation in a single event. If the person decides to become a regular member within one month of the event they only have to pay the remaining membership fee and then will enjoy all the benefits of a member in good standing. Please see this option found in the website shop listed with memberships.

In order to provide the quality level of food, beverages, and amenities for this workshop it is necessary to charge a small activity fee to help offset the costs. Please check the below entry for the fee.

Upon completion of this registration form please go to the website Shop and select the activity and membership (if applicable) to complete your payments for this event.

Workshop fees*

$40 Membership new or renewal$25 Limited Event Membership$30 Activity fee

Signature (type legal name)

Please go to the website Shop and pay fees. Activity fee is found under CRBG Regional Event Activity Fees.

Registration is NOT complete until the fees are paid.