Registration: Regional Gathering 2018 (May 25, 2018 - May 28, 2018 )

Please fill out the form below to join us for the San Diego Mensa "Through the Kaleidoscope" Regional Gathering 2018.

USER INFORMATION
Mensa ID Number:
First Name:
Last Name:
City:
State:
Zip:
Email:
Confirm Email:
Phone:
Full Weekend ...... Adults :
Teens (ages 13-17) :
Children:
Friday Only:..................... Adults :
Teens (ages 13-17) :
Children:
Saturday Only:.................... Adults:
Teens (ages 13-17) :
Children:
Sunday Only:..................... Adults:
Teens (ages 13-17) :
Children:
Saturday Dinner Only: :
Would you like to help with hospitality? :
Yes  No  
Would you like to help at the Registration Desk? :
Yes  No  
Would you like to help shepherd speakers? :
Yes  No  
Please list the name(s) as you would like name badges to appear:
Comments::
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I agree to the terms and conditions:
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