Pre-registration Form
Adults $10.00
Children $5.00

For Express Line service prepay by mailing in a registration with a check or money order made out to the Richwood Chamber of Commerce by April 14, 2006.  Be sure to include a self addressed stamped envelope for return of advanced registration.

Mail to: 
Richwood Chamber of Commerce
PO Box 267
Richwood, WV  26261
Phone: (304) 846-6790

NAME________________________________________________________

MAILING ADDRESS_____________________________________________

CITY_______________________________ STATE____ ZIP_____________

# OF ADULTS________ # OF CHILDREN________ TOTAL $_____________