Smokeout Entry Form

DO NOT USE THIS FORM YET. WE ARE UPDATING IT AND ANYTHING YOU DO WILL BE LOST!!!!!

Registration Form to Attend Las Vegas Smokeout
April 2-5, 2009

* = required

* First Name: * Last Name:

* Email Address (if you specify an email, we send a copy of the form to you):

Phone (optional if you specified Email above):

* City: * State: * Zip: * Country:

Check all sections below. We have applied common defaults you may not agree with!

Where are you staying? Alexis Park Local Other
What days will you attend? Thu Fri Sat Sun

THURSDAY APRIL 2, 2008
06:00 PM - Dinner HofBrauhaus Yes No
10:00 PM - Social at Buffalo Yes No

FRIDAY APRIL 3, 2008
12:00 NOON - Singles Party

Yes No
13:00 (1PM) - Indoor Skydiving Yes No
14:00 (2PM) - Cigar Crawl Yes No
15:00 (3PM) - Dip Tasting Party

Yes No
16:00 (4PM) - Roller Coaster Ride Yes No
17:00 (5PM) - Dinner "Pomplemousse" Yes No
17:00 (5PM) - Dinner "Harley Davidson Cafe" Yes No
18:00 (6PM) - Welcome Cocktail Party

Yes No
21:00 (9PM) - Piss Party

Yes No
21:30 (9:30PM) - Buffalo Beer Bust Yes No
23:45 (12:45PM) - Underwear Party

Yes No

SATURDAY APRIL 4, 2008
06:00 - 09:30 (6AM) - Breakfast Buffet Yes No
10:00 (10AM) - Motorcycle Ride Yes No
12:00 (12 NOON) - Sushi Lunch Yes No
19:00 (7PM) - Cigar Poker Party

Yes No
20:00 (8PM) - Pipe Social Yes No
21:00 (9PM) - Leather Uniform Party

Yes No
23:30 (11:30PM) - Play Party HAWKS GYM

Yes No
23:30 (11:30PM) - International Bondage Club

Yes No
USING SHUTTLE SERVICE BETWEEN ABOVE SATURDAY EVENTS

Yes No

SUNDAY APRIL 5, 2008
11:00 (11AM) - Brunch Hard Rock Cafe Yes No
16:00 (4PM) - Buffalo Beer Bust Yes No

Selecting any check boxes in this T-Shirt section will imply you want to purchase T-Shirts at$15 each
Youmust check the check boxin order for the specific size with that quantity to take effect

    M        Quantity
    L         Quantity
    XL     Quantity
    XXL Quantity

Chosing any check box above for T-shirts requires you to pay for T-Shirts using PayPal or Money Order

Click SUBMIT before going to the MONEY ORDER or PAYPAL section please

Click SUBMIT buttonfirstwhich will tally up your totals. You can then return to this page and click appropriate PayPal buttons to make payment. Be aware that sending the email does not guarantee a T-shirt unless you also click the BUY NOW buttons for the appropriate items.