Registration Fees Prior to October 7th: $150.00 After October 7th: $200.00 Fees for LRTC Members Prior to October 7th: $100.00 After October 7th: $150.00 (For reduced rate, registration form and fees MUST ARRIVE at the Registration address by October 7th.) Please use a separate form for each participant.	Wednesday 10-18-06 through Sunday 10-22-06* (Sunday activities focus on new adopters.)	SEND REGISTRATIONS TO: LRTC WHW’06 C/O Sharon Lamm 11345 Silver Lane Stagecoach NV 89429 QUESTIONS? Sharon Lamm     775-629-0781 sharon@kbrhorse.net Betty Retzer     775-629-9197 betty@whmentors.org Willis Lamm     775-629-0781 willis@kbrhorse.net

Name: _______________________________________________ E-mail: ________________________ Address: ____________________________________________________________________________                     Street/PO Box             City         State         Zip Code Home Phone: ________________________________ Cell Phone: ______________________________ Emergency Contact: _____________________________________ Phone # ______________________ Applicant Signature: ________________________________________ Birth date if Minor: _________                                     (Guardian if applicant is a minor)

Workshop Registration:	$_____________ (See above for registration fees)
LRTC Membership:	$_____________ ($25.00 family / $15.00 single)
Total:	$_____________

* Current membership required to take LRTC member discount.         * Must include a membership application form if a new member. Refunds Refunds requested prior to October 7th will be subject to a $25.00 Service charge. Refunds requested after October 7th will be subject to a $35.00 service charge. * All refunds will be issued after the end of the workshop.

Office Use Only Date Rec'd __________________ Check# ______________________ Amount $ ____________________ Initial _____________________