OryCon 22 Masquerade Registration Form

For Administrative Use: Presentation #  __________________

                      (PLEASE PRINT CLEARLY)

Name: __________________________________  Badge Number: ___________

Address: _____________________________________________________________

City: _________________  State: _______________  Zip: ____________________

Phone Number: ________________ Email Address: ____________________

Costume Name ______________________________________________________

Description __________________________________________________________

Designed by (if different than entrant)______________________________

Made by (if different than entrant)___________________________________

Number of people on stage in presentation ________________________

Names(s) of Additional Persons:

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Please fill out and attach Tech and MC information!

Division: 
Novice ___ Journeyman ___ Master___  Non Competing ___ 
Young Fan (self made) ___ Young Fan (Adult made) ___

General Categories (check all that apply): SF __  Fantasy __  Historical __  
Original ___ Recreation  ___   (Documentation should be handed in with
registration)  

General Mood:  Horror ___  Humorous ___  Beautiful ___ Dramatic ___   
Walk On ___ Other ___

Costume Color (check one) :  Black ___ Brown ___  Red ___ Orange ___  
Yellow ___  Green ___  Blue ___  Violet ___ White ___ Gold ___ Silver ___
Flesh ___  Other: ______________

Presentation # ________


Liability Release
(ALL particpants MUST read AND sign before going on state. A parent or
guardian must sign for a minor.)

I/We have read and understood the rules for this Masquerade as set forth in
the instructions and agree to abide by them. Further, I/We agree to permit
photography and videotaping, and to allow the sale/dissemination of these
photos and tapes by Orycon.  Further, I/We do agree to hold the convention,
its organizers and the facility both severally and individually blameless
for any accident and/or injury suffered by me/us during the course of this
Masquerade and its rehearsals except in cases of gross negligence on the
part of those cited above.


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(please include your badge number after your name)