Warpstock, Inc.                                       http://www.warpstock.org

Doubletree Hotel San Francisco Airport                  October 18 - 19,  2003


                         Warpstock 2003 Registration Form
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To register for Warpstock 2003, fill out the form and send it with a check or
money order to the following address :

     Warpstock 2003 - C/O Stan Sidlov
     187 Hilltop Court
     Pompton Lakes, New Jersey 07442
     United States of America

Checks payable to "Warpstock, Inc."with "WARPSTOCK" written on the memo field.


Please note that Sep.5, 2003 is the cut-off date for mail-in registrations.


     NAME / COMPANY :  ___________________________________________________
     E-MAIL :  ___________________________________________________________
     STREET ADDRESS : ____________________________________________________
     CITY :  _____________________________________________________________
     STATE OR PROVINCE :  ________________________________________________
     POSTAL CODE :  ______________________________________________________
     COUNTRY :  __________________________________________________________

     NR OF VENDOR BOOTHS (US $400, including 2 free admissions) :   ______
     NR OF 2 DAY REGISTRATIONS (US $140 , $99 until 09/05/03) :     ______
     NR OF SATURDAY ONLY REGISTRATIONS (US $90) :                   ______
     NR OF SUNDAY ONLY REGISTRATIONS (US $90) :                     ______

     WARPSTOCK SPONSORING MEMBER (NO ADMITTANCE, US $48) :          ______


     What would you like to have printed on your Warpstock badge?

     BADGE 1    NAME : ___________________________________________________
                CITY, STATE : ____________________________________________
                INFO : ___________________________________________________

     BADGE 2    NAME : ___________________________________________________
                CITY, STATE :_____________________________________________
                INFO : ___________________________________________________


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