Please fill out the following form and click "Submit".

Your Email:
Your Phone:

First Registrant

Name:
Name on Badge (only if different):
Town & State:
Local Group:
Mensa office, or other badge info:
Mensa member?yesno
First Snowball?yesno
Purchasing Friday Dinner? yesno
Purchasing Saturday Lunch? yesno
Purchasing Saturday Dinner? yesno

Second Registrant

Name:
Name on Badge (only if different):
Town & State:
Local Group:
Mensa office, or other badge info:
Mensa member?yesno
First Snowball?yesno
Purchasing Friday Dinner? yesno
Purchasing Saturday Lunch? yesno
Purchasing Saturday Dinner? yesno

Third Registrant

Name:
Name on Badge (only if different):
Town & State:
Local Group:
Mensa office, or other badge info:
Mensa member?yesno
First Snowball?yesno
Purchasing Friday Dinner? yesno
Purchasing Saturday Lunch? yesno
Purchasing Saturday Dinner? yesno

Thank you!