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Registration Form

 

  

  Last Name:  

  First Name:  

  Street Address:

 City:

  State:   

  Zip Code:

  Country:  

  Phone:

  Email: 

  Sex:  

Male  Female

  Colour:   

 

  Size:   

 

  Costume Options:

  Preferred Drinks:

  Amount in US$

 

                         Payment Method

Credit Card Number:  

Credit Card Type:

Visa Master Card

Expiration Date:

 

 

 

 

 

 

REGISTRATION PROCEDURE IF NOT PAYING BY CREDIT CARD

 

Fill out and submit Registration Form. Wire transfer or deposit your payment to: Republic Bank Limited, Long Circular Mall Branch, Account Number - 560109813101.

In addition you can have a cheque or bank draft made payable to : NICOLA GOMEZ and mail it to her at 12 Anderson Terrace, Maraval, Trinidad, W.I.

 

Upon receipt of payment, you will be contacted via email or telephone and your receipt will be attached to your registration form for collection.

 

Local masqueraders wishing to pay by cash or cheque can contact:

Rudy     : 685-7409

Georgie : 776-6468

Richard : 795-0050

 

MINIMUM DEPOSIT  - $500.00 TT    $83.00 US

ALL OVERSEAS REGISTRANTS MUST PAY IN FULL.