2021 Summer Meeting

2021 Summer Meeting

2021 Summer Meeting – June 11 – 12th, 2021
Hotel Mead
451 E Grand Ave |. Wisconsin Rapids, WI 54494
June 11 – 12th, 2021

Primary Registrant Name*
First Last
Primary Phone
Primary Address
Street Address Address Line 2 City State ZIP Code
Primary Email
Additional Member or Registrant
If you are registering as a family, please provide the first and last names and email address of everyone attending:
First Name Last Name Email Address
Friday Night Social - Pizza Buffet
Price: $15.00 Quantity:
Saturday Meeting & Meal (Member)
Price: $25.00 Quantity:
Saturday Meeting & Meal (Non-Member)
Price: $35.00 Quantity:
Payment
Pay via:*
- Online
- Mail in Check
Please send check payment to:
WHPA
36510 165th Ave
Stanley, WI 54768
Billing Name*
First Last
Billing Address*
Street Address Address Line 2 City State ZIP Code
Billing Email*
Billing Phone*
Total
$0.00
Credit Card*

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name

Payment

First Name	Last Name	Email Address