Registration Form
International Women Fly Fishers
Rendezvous 2006 - Keystone, Colorado 
Thursday August 17 – Sunday August 20, 2006

Name: ________________________________________________________________________

Address: ______________________________________________________________________

Phone: _______________________________________cell:_____________________________

Email: ________________________________________________________________________

Club Affiliation: ________________________________________________________________

I am a beginner ___ intermediate ___ advanced ___ fly fisher.

I am a current IWFF member-$50 ___ I am a new member of IWFF-$75 ___

WAIVER OF LIABILITY/PHOTOGRAPH RELEASE

In consideration of participating in International Women Fly Fishing activities and/or events, I hereby indemnify and hold harmless International Women Fly Fishers, its Officers, Board of Directors, Members and Agents from any and all liability for injury suffered by myself, or my minor children, arising from or connected with club activities and events. I assume all the risk for any injury received and agree to hold the International Women Fly Fishers and Char Bloom, LLC free and harmless from any and all costs, expenses and attorneys fees incurred in connection with any injury, claim or demand brought thereon. I further agree to be bound by all terms and conditions set forth in the club by-laws and regulations.

I further hereby authorize and consent to the use and reproduction by International Women Fly Fishers of photographs taken of me, or my minor children, at the International Women Fly Fishers 2006 Keystone, Colorado Regional Rendezvous. Any such photographs may be used in the International Women Fly Fishers newsletter, web site, or any other International Women Fly Fishers publications, promotions or educational materials.

DATED: __________________________________________________________________________

Signature __________________________________________________________________________

Please forward a check payable to IWFF and this form to:

Char Bloom
Char Bloom, LLC
0242 Elk Crossing Lane
Keystone, Colorado 80435

Submission of this form and payment of the applicable registration fee is required to secure your registration and to book room reservations at the River Cabin Lodges.

Registration Deadline: July 1, 2006 or by arrangement.  Space is Limited
For more information: Contact Char Bloom at char@charbloom.com