To Register print and mail this form to:

Safe-Capture International, Inc.
P.O. Box 206
Mt. Horeb, WI 53572 USA


Registration Form: White-tail Weekend Seminar

Program Location _______________________________

Agency _______________________________________

Address ______________________________________

              ______________________________________

Program Dates __________________________________

Telephone _____________________________________

Name 1 _______________________________________

Name 2 _______________________________________

Walk-In Registration will be accepted if space allows

(Early Registration must be postmarked by June 12, 2002!)

O July 12 Registration :    $475 Early     $525 General

O July 13 Registration :    $500 Early     $550 General

O Both Programs:  (Save $50.00)     $925 Early     $1025 General

Total Number of Registrations _______________         Total Registration Fee Enclosed _______________

(Check, VISA, MasterCard are accepted for advance registration)