I wouldn't miss Wayne's World for all the herbal tea on Park Ave!!!!

Here's my check/money order for $_____ to cover _____ reservations.

PLEASE PRINT:

Name _______________________________________________

Street _______________________________________________

City ________________________ State ____ ZIP ____________

Home Phone: _________________________________________

Email: _________________________________________

Signature: _________________________________________

Name(s) as you'd like them to appear on your name tag(s):

____________________________________________________

____________________________________________________

Please mail your check/money order (payable to Wayne's World 2000) along with this completed form to:

            Wayne's World 2000
            P.O. Box 10825
            Rochester, NY 14610-0825

By submitting this form, I give organizers of Wayne's World 2000 permission to publish photos taken of me/us at the event in a "virtual photo album" to be posted on the official Web site (www.ginnie.com/waynesworld2000/). I understand that these images will be available to me and others for viewing and downloading. Proceeds from this event (if any) will benefit local charitable causes.