Three Rivers Leather Club Summer Jamboree Registration

 












	
First Name (required)

Last Name (required)
	


	
Phone (required)
	


	
Your Email (required)
	


	
Street Address (required)
	


	
City (required)

State (required)

Zip (required)
	


	
Club Affiliation
	


	
Emergency Contact Name

Emergency Contact Phone (required)
	



	
Accommodations:HotelTent CampingRV/Trailer
	



	
Travel:DrivingFlyingBus/Train

If you anticipate needing a ride, please let us know.
	



	
Dietary:NoneVeganVegetarianSpecial Dietary Needs
	


	
Special Dietary:
	


Yes, I Would you be interested in a Saturday afternoon outing to Fallingwater.

- Not included in registration/add't cost $32. Pay at venue. Transportation limited seating to 25.



Please read and accept the terms below 

(required)  Terms of Purchase:  I hereby certify that I am 21 years of age or older and that I will abide by all rules and regulations pertaining to this event. I will not use illegal drugs, perform illegal acts, or hold Three Rivers Leather Club (TRLC) or participating venues responsible for damages or personal injuries to my personal property or self. This is a private event; Three Rivers Leather Club (TRLC), reserves the right to refuse admission or eject any person for any reason whatsoever.