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Names of all Registrants on Order *

Total Number of Registrations to Purchase: *

Name on Credit Card/ PayPal Account *

Email: *

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Holiday Inn Cincinnati Airport

Best Phone Number to Reach Purchaser

$25 In Advance Until November 3, 2022

Buckeye Roundup Advance Registration

REGISTRATION:

$30.00 at Conference (registration is non-refundable)

November 4 - 6, 2022

Questions? Please contact:
Mike J. (513) 240-1658
Liz S. (513) 884-0661

Carol S. (513) 265-5024

ONLINE REGISTRATION

COMPLETE BELOW

PAPER SUBMISSION ONLY

PRINT AND SEND IN THE BELOW INFORMATION WITH A $25.00 CHECK OR MONEY ORDER

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Full Name_________________________________________________
Address __________________________________________________
City _______________________State__________Zip_____________
E-Mail Address ____________________________________________
Phone _____________________

AA__________________________

Alanon______________________

Make Checks Payable to:
Buckeye Roundup

HOST COMMITTEE
PO Box 30084
Cincinnati, Ohio 45230