Contest & Convention Registration Form
Name ___________________________________ eMail _______________________________________
Billing Address ________________________________________________________________________
City _________________________ State __________ ZIP _________ Phone ___________________
Quartet ____________________________________ Chapter ____________________________________
• Registrations WILL NOT be MAILED! ORDER REGISTRATIONS:
• Pick up at the Registration Desk at the Convention
• NO COD or phone orders accepted!
• Payent for the full amount MUST accompany this request. Mail: M-AD Registrations
• EARLY BIRD DISCOUNT of $5 expires 30 days prior to each 9013 Hedgerow Way
Baltimore, MD 21236-1919
• Order on-line and pick your seats!
• Seating chart available on-line (click on Contest Name to
open seating chart in a new window NO PHONE OR COD ORDERS!
DISTRICT CONVENTIONS: (All seats reserved. Single Event Reserved seats available at the contest) QUAN $ AMT
Spring Convention – March 15 & 16, 2013 Sheraton Hotel, Parsippany, NJ (Not available until October 15, 2012)
Fall Convention – October 12 & 13, 2012 Premium Seats - $45 Before Sep 9 / $50 After) _____ $ _______
Roland C. Powell Convention Center, Ocean City, MD Regular Seats - $35 Before Sep 9 / $40 After) _____ $ _______
Sat Jamboree Only - - - - $25 ______ $ _______
DIVISION CONTESTS: (All Division Contests will be available for purchase after October 15th, 2012)
Southern / Western Division Convention – April 26 & 27, 2013 Hyatt Regency Hotel, Reston, VA
Atlantic / Northern Division Convention – May 31 & June 1, 2013 Crowne Plaza Hotel, Cherry Hill, NJ
MAD Endowment Fund Contribution - - - - - - - - - - - - - - - - - - - (Optional) $ ______
[ * Early Bird Discounts expire 30 days prior to each contest. Full amount of registrations MUST accompany order
and be postmarker prior to date to earn discount. List special requests on back of form.] TOTAL AMOUNT DUE $_________
Cut off date for on-line and mail orders is 7 days prior to each contest. After that, purchase on-site.
Check # _____________ (Make payable to MID-ATLANTIC DISTRICT) Total ___________
Credit Card: We accept [Card holders name and address must appear at top]
Number: _______ - _______ - _______ - _______ Exp Date: ____/_____ Security Code: _______
I authorize the Mid-Atlantic District to charge my credit card with amount indicated above: _____________________________