* Consider joining GALA: For the cost of membership

($40 for the July-June period), adults save up to $50

when registering for this conference. Plus, you
gain the benefits of receiving the GALA newsletter and
membership directory, as well as having access to the
GALA library. (See reverse side for more information.)

Back to Basics

Conference 2011 Registration Form

Name(s) as you want them to appear on name tag(s):

MEMBER

FIRST CONFERENCE?

Name (#1) ________________________________________________________________

YES

NO

YES

NO

Name (#2) ________________________________________________________________

YES

NO

YES

NO

Junior A ___________________________________________________

Age ________

YES

NO

YES

NO

Junior B ___________________________________________________

Age ________

YES

NO

YES

NO

Farm name _____________________________________________________

Email ______________________________________

Address _______________________________________________________________________________________________________
City ____________________________________

State _______

Zip ______________ Phone _____________________________

Circle #1 and/or #2, A, or B (corresponding to the names above) to indicate which person is registering for the following:
FULL PACKAGE: Includes all programs and meals for Thursday night, Friday, Saturday, and Sunday morning.
Adult singles:
Early registration (postmarked by 9/15/11)
Late registration (postmarked after 9/15/11)
Adult couples:
(any two adults registering from the same farm)
Early registration (postmarked by 9/15/11)
Late registration (postmarked after 9/15/11)
Juniors (under 18): Registration

MEMBER*

CIRCLE

NON-MEMBER

$280
$305

#1
#1

#2
#2

$330
$355

............

$490
$520
$190

#1
#1
A

#2
#2
B

$540
$570
$190

............

............

............
............

$ _____________
$ _____________

$ _____________
$ _____________
$ _____________

PARTIAL PACKAGE 1: Includes all programs and meals for Friday night, Saturday, and Sunday morning.
Adult singles:
Early registration (postmarked by 9/15/11)
Late registration (postmarked after 9/15/11)
Adult couples:
(any two adults registering from the same farm)
Early registration (postmarked by 9/15/11)
Late registration (postmarked after 9/15/11)
Juniors (under 18): Registration

MEMBER*

CIRCLE

NON-MEMBER

$245
$270

#1
#1

#2
#2

$295
$320

............

$420
$450
$150

#1
#1
A

#2
#2
B

$470
$500
$150

............

............

............
............

$ _____________
$ _____________

$ _____________
$ _____________
$ _____________

PARTIAL PACKAGE 2: Includes all programs and meals for Saturday and Sunday morning.
Adult singles:
Early registration (postmarked by 9/15/11)
Late registration (postmarked after 9/15/11)
Adult couples:
(any two adults registering from the same farm)
Early registration (postmarked by 9/15/11)
Late registration (postmarked after 9/15/11)
Juniors (under 18): Registration

MEMBER*

CIRCLE

NON-MEMBER

$205
$230

#1
#1

#2
#2

$255
$280

............

$340
$370
$125

#1
#1
A

#2
#2
B

$390
$420
$125

............

............

$ _____________
$ _____________

............

$ _____________
$ _____________
$ _____________

S___ M____ L____ XL ____ 2XL____ $15.95 each . . . . . . . .

$ _____________

3XL___ 4XL____ 5XL____ 6XL____

$18.95 each . . . . . . . .

$ _____________

Page 1 TOTAL

$ _____________

............

ADDITIONAL INFORMATION
I would like to purchase a GALA sweatshirt

I/WE require vegetarian meals

I/WE will be attending the Ice Breaker

#1 #2 A B
#1 #2 A B

......

EXHIBITS: (see registration booklet for details)

CIRCLE IF YES

Vendor space approx. 100 sq. feet,

two tables, two chairs
Full meals only package (per person)
Farm/Product Display (8 x 18 table)

Electric

# _____

$100

............

$ _____________

# _____
# _____

$175
$60

............

Electric

$ _____________
$ _____________

............

SPONSORSHIP: Deadline is September 15 if you wish to be listed in the notebook.

For your convenience, if you wish to make a sponsorship payment with this registration.
(See booklet for details on advertisement space and recognition.)
Platinum Sponsor
Gold Sponsor
Silver Sponsor
Speaker Sponsor
Refreshment Sponsor
Fiber Room Sponsor
Friends of GALA

Free full-page tab ad, plus more . . . . . . . . . . .

Free full-page tab ad, plus more . . . . . . . . . . .
Free full-page tab ad, plus more . . . . . . . . . . .
Free full-page ad, plus more . . . . . . . . . . . . . .
Free half-page ad, plus more . . . . . . . . . . . . . .
Free 1/4-page ad, plus more . . . . . . . . . . . . . .
Free business card size ad, plus more . . . . .

$1000
$500
$250
$175
$100
$50
$25

............

$110
$80
$40
$25
$15

............

............
............
............
............
............
............

$
$
$
$
$
$
$

_____________
_____________
_____________
_____________
_____________
_____________
_____________

$
$
$
$
$

_____________
_____________
_____________
_____________
_____________

CONFERENCE NOTEBOOK ADVERTISING: Deadline is September 15.

For your convenience, if you wish to make an ad payment with this registration.
(See booklet for details.)
Full-page tab ad
Full-page ad
Half-page tab ad
1/4-page tab ad
Business card size ad

.........................................
.........................................
.........................................
.........................................
.........................................

VOLUNTEERS NEEDED DURING CONFERENCE:

I/We are willing to be Speaker Hosts
Suggested speaker to host: ________________________
I/We are willing to help set up on Thursday afternoon.
I/We are willing to help take down on Sunday morning.

#1 #2

............
............
............
............

PAGE 1 TOTAL

$ _____________

TOTAL

$ _____________

#1 #2 A B
#1 #2 A B

CONFERENCE FUNDRAISING:
Items to be donated: ______________________________________________________________________________________
____________________________________________________________
Cash donation for llama research. ! Will bring to conference

Approx. value: $ ____________________________

! Will send by mail _______________________________________

PAYMENT:
! Check enclosed
Make payable to GALA CONFERENCE 2011, c/o Patricia Fiocchetta, 78 Day Street, Granby, CT 06035-2900
! Credit card
Charge my

! Visa

! MasterCard

Amount: ______________________________________

Card Number: ___________________________________________

Exp.Date: _____________________________________

Name on card (print): ______________________________________

Signature: ____________________________________

Acceptance of registrations will be determined by the postmark on the envelope and full payment.
Cancellations with full refunds will be allowed until 10/19/11. Refunds will be made post conference.
JOIN OR RENEW GALA MEMBERSHIP:
$40
Membership from 7/1/11 to 6/30/12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Download membership form from www.galaonline.org and attach. (See information on the form.)
Please write a separate check.
! Check if a renewal
Please make a copy of registration form for your records.