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Registration Form Teens for 4 to a room $150. 00 -$135. 00 before May 1st Sponsors for 2 in a room $193. 00 -$178. 00 before May 1st


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MidLake 2015

May 22nd, 23rd and 24th

Devils Head Resort 56330 Bluff Road Merrimac, WI 53561

Registration Form


Teens for 4 to a room $150.00 --$135.00 before May 1st

Sponsors for 2 in a room $193.00 --$178.00 before May 1st

Sponsors for 1 in a room $282.00 ---$267.00 before May 1st

No Registrations will be accepted after May 10th.
Name:_____________________________________________________________________________

Gender


  • Male

  • Female

[ ] Disability/Special room needs: I request a room that is on the same level as the Midlake events

Address:_____________________________________________________________________________________

Name of Parent/Legal Guardian:_________________________________________________________________

Phone #:______________________________________________________________________________________

24 hour emergency contact:_____________________________________________________________________

Phone #:______________________________________________________________________________________

I am a :

  • Sponsor Sponsor ID #_______________________________

  • Teen

  • Certified life guard and am willing to volunteer at the pool.

My Sponsors Name:________________________________ Group:___________________________________

Roommate Names Group Rmmates ph #Sponsors Name



1)____________________________________________________________________________

2)____________________________________________________________________________

3)____________________________________________________________________________

Please Circle:

Tshirts: $15 each Hoodie: $35.00
Small Medium Large Extra Large
Send this form along with your check or money order for convention cost and t-shirt payable to MidLake 2015

3726 Bridge St Nw PO Box 206



Saint Francis, MN 55070

Phone # 612-889-8965

Email: evekaldahl@gmail.com


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