NRBA Conference Registration – Spring 2012

Name / Business________________________________________________________________ 

Address______________________________________________________________________

City_______________________________________State_________________ ZIP__________

Phone_______________________________   Email___________________________________

NRBA membership is open to all who support the goals and activities of the organization. All memberships are family memberships. Benefits include newsletter subscription, use of the association library, and notification of blacksmithing conferences.

NRBA Membership for 2012, if not yet paid:                       $20.                  _________

Full conference, including one Saturday dinner:                    $50.                  _________

Credit for auction contribution:                                             -$10.                 _________

One-day attendance, without dinner:                                     $25.                  _________

Extra Saturday dinners; each:                                                 $10.                  _________

                        Total:                                                                                        _________

Please make checks payable to NRBA.  

Mail to:  Scott Espelin, 833 Hummingbird Lane, Butte, MT 59701

Disclosure/Assumption of Risk: I hereby acknowledge that by attending the Spring 2012 NRBA Conference, to be held at Jim Bolinger’s St. Mary’s Forge, 415 St. Mary’s Road, Stevensville, MT, 59870, I assume for myself and all dependents accompanying me all risks, hazards and dangers that are present on the property by reason of its location, the terrain, and various equipment located on the property. I specifically waive and release NRBA, its Board and Members, St. Mary’s Forge, Jim Bolinger, his family, company and employees from any liability, loss, injury or damage which may occur as the result of my and/or my dependants’ attendance at this Conference and presence on the property. Children and non-blacksmiths are not allowed in the forging area or the use of forging equipment. All persons, children, non-blacksmiths and blacksmiths are required to have and to use personal safety equipment (eye and hearing protection).

All adults must sign for themselves and dependents:

Signature:________________________Printed Name:______________________ Date:_______

Signature:________________________Printed Name:______________________ Date:_______

PrintedNames of Children:________________________________________________________

______________________________________________________________________