To Register by Email, Complete Each Section, Save As Yourlastname Paleofestregistration

To Register by Email, Complete Each Section, Save As Yourlastname Paleofestregistration

Thank you for registering for PaleoFest! PaleoFest 2017 promises to be one of our most exciting PaleoFests yet and we look forward to seeing you in March!

Please note, your registration is not complete until payment is received; tickets or passes cannot be held without payment. All sales are final.

Keep a copy of this registration for your records, you will be emailed a receipt once your transaction is complete.

To register by email, complete each section, save as “YourLastName_PaleoFestRegistration” and email it to .

To register by post, mail your registration to:Burpee Museum of Natural History

Attn: 2017 PaleoFest Registration

737 N. Main Street

Rockford, IL 61103

Customer Information:

Last Name______First Name ______

Email ______Phone ______

Address ______

City ______State ______ZIP ______

Payment Information:

☐Cash, enclosed ☐Check, Check # ______, enclosed ☐Credit Card

Card Type: ☐Visa☐MasterCard☐American Express☐Discover☐Other

Account Number: ______

Expiration Date: Click here to enter a date.CVV: ______ZIP: ______

☐Please call ______for my credit card payment information.

Burpee Museum Presents: Dr. Matt Lamanna at Paleofest 2017
PaleoFest’s keynote address and fundraiser will be held at Burpee Museum of Natural History on Saturday March 4th, 2017. Schedule: Dinner, 6:30pm, Keynote, 7:30 pm. Prize Pull & Live Auction included.
Tickets / Price / Quantity / Subtotal
General Public / $60 / 0 / $0.00
Burpee Member / $50 / 0 / $0.00
Student (w/ID) / $50 / 0 / $0.00
Would you like a vegetarian meal? / Yes No / Qty:
PaleoFest Mixer
Social event including 1 free drink ticket for either beer or wine. Access to Burpee Museum and its exhibits all from 4:30 – 6:30 pm.
Tickets / Price / Quantity / Subtotal
General Admission / $10 / 0 / $0.00
Paleofest Presentation Passes
Join us for the 19th annual Paleofest lecture series! This year’s series features 16 world renowned Paleontologists. Includes PaleoFest Admission.
Tickets / Price / Quantity / Subtotal
2-Day General Public / $85 / 0 / $0.00
2-Day Burpee Member or Student (w/ID) / $70 / 0 / $0.00
1-Day General Public / $65 / 0 / $0.00
1-Day Burpee Member or Student (w/ID) / $50 / 0 / $0.00
Which Day? / Choose an item. /
PaleoPackage – 2 Day + Dinner
This exclusive package combines a 2 day lecture pass and the keynote dinner presentation for a special savings!
Tickets / Price / Quantity / Subtotal
General Public / $135 / 0 / $0.00
Members or Students (w/ID) / $110 / 0 / $0.00
Kids & Family Workshops
(Workshop Descriptions @
The Infamous Tully Monster
Saturday, March 4th 2017
11am – 12am. Recommended for ALL ages, must be accompanied by an Adult.
Tickets / Price / Quantity / Subtotal
General Public / $25 / 0 / $0.00
Burpee Member / $15 / 0 / $0.00
Homer & The Gang
Saturday, March 4th 2017
1:30 – 2:30pm. Recommended for ALL ages, must be accompanied by an Adult.
Tickets / Price / Quantity / Subtotal
General Public / $25 / 0 / $0.00
Burpee Member / $15 / 0 / $0.00
T rex Mysteries?
Sunday, March 5th 2017
11am – 12pm. Recommended for ALL ages, must be accompanied by an Adult.
Tickets / Price / Quantity / Subtotal
General Public / $25 / 0 / $0.00
Burpee Member / $15 / 0 / $0.00
The Weird Dinosaurs of Lost Gondwanaland
Sunday, March 5th 2017
1:30 – 2:30pm. Recommended for ALL ages, must be accompanied by an Adult.
Tickets / Price / Quantity / Subtotal
General Public / $25 / 0 / $0.00
Burpee Member / $15 / 0 / $0.00
IMPORTANT: Press CTRL+A then Press F9 to update your Subtotals and Total amount. / TOTAL: / $0.00