First Name:     Last Name:
Please submit separate form for each registrant.

Address:   

City:        Prov:     Postal Code:

Telephone:(home)  (work) (cell)

Email:        Theatre BC Club Card (membership) #:

Expiry Date:    Theatre BC Zone:

Early Bird Registration Package for MAINSTAGE 2007

  TBC Member Rate ($185.00 + 11.10 GST) = $196.10 
                     TBC Club Card must be valid at date of event to get Member rate.
                (After Apr.15th - $222.60 incl. Banquet & GST )

   Non- Member Rate ($215.00 + 12.90 GST) = $227.90
               (After Apr.15th - $265.00 incl. Banquet & GST)

   MAINSTAGE 2007 Patronage = $50.00
                       Patrons receive a Charitable Tax Receipt for the full amount
                        Names will be displayed in the Theatre lobby, in the souvenir program, and on the M2007                           website (permanent archive)    

Total Payable to "Theatre BC's MAINSTAGE 2007" :   $

Payment Method :  Cheque Money Order Visa MasterCard
Please make cheque payable to Theatre BC.  Mail cheque and registration form to:  
Theatre BC
PO Box 2031, Nanaimo, BC V9R 6X6
 or Fax: 250-714-0213

Credit Card #:   

Expiry Date: Name on Card:

Please submit separate form for each registrant.