Rustycon 26: Membership Services: Online Registration

Membership Services: Online Registration

If you only have one name (e.g. "Cher" or "Madonna") then please use the Surname field.

All fields with asterisks (*) are required fields. If you leave them blank you will not be able to register. You will need cookies and javascript turned on for this form to work.

Given Name:

Middle Name/Initial:

* Surame:

Badge Name (Leave blank if you want the legal name to be the badge name.):

* Street Address:

* City:

* State/Province:

* Zip/Postal Code:

* Country:

Home Phone:

E-mail Address: (If this membership is for a child under 13 years, please enter in a guardian’s e-mail address instead.

Would you like to be added to the Rustycon Members e-mailing list? Yes No
(No spam, we promise - just Rustycon Announcements and such)

Would you be willing to volunteer to help us at Rustycon? Yes

If so in what areas would you like to assist:

* Is the attending member 18 or older? Yes

Is this an adult or child membership?
Adult $30
Teen 13 - 17 $30
Child 7 - 12 $15

Guardian Signature (Name):
The guardian name listed here will be REQUIRED
to sign a release form when the child/teen picks up their badge. Entering a name here also indicates that the person responsible has read and agrees to Rustycon’s policies on children attending the convention.

Please enter in the special registration code you see in the image. This is to prevent automatic submissions by netbots.

By submitting this registration form, you are indicating that you have read and agree to the policies listed below as well as other Rustycon policies that are contained within this website as well as those posted at the convention itself as well as those printed in the program and pocket program books.

Membership Policy Statement:

I agree to abide by the rules and policies of this convention as set forth in the program book and or pocket program and or website. I also understand that I am liable to the hotel and Rustycon for any damages I cause to the hotel or Ruction’s property.

Children’s Policy Statement:

As parent or guardian, I agree that I am responsible for the above minor. I am responsible for the actions of this member. I am aware of Rustycon’s published Children’s Policy.

I agree to release and hold harmless Rustycon, its members, trustees, agents, officers, contractors, volunteers and employees from and against any and all claims, demands, actions, complaints, suits or other forms of liability that shall arise out of or by reason of, or be caused by the use of my, or for those of whom I am the legal guardian likenesses or photographs, video tape, audio tape, and/or interview, likeness or voice on television, radio or motion pictures, still pictures, or in the print medium, or on the Internet or any other electronic/digital or photographic medium “here after referred to as audio/visual record”.

I hereby revoke all claims to any, audio/visual record of myself or those for whom I am the legal guardian while at a Rustycon function and obtained by a Rustycon staff person or representative while I am in attendance at a Rustycon function. I also consent to Rustycon’s use of my, or those for whom I am the legal guardian audio/visual records on the Internet or on a promotional medium such as but not limited to CD, DVD, or any other electronic/digital, or printed media or reproduction.

Rustycon pledges that any audio/visual record will only be used to promote Rustycon or a Rustycon sponsored event, and that no third party licenses will be granted to anyone for any other purpose, nor will the audio/visual record be distributed with licenses freely for any other purpose, nor will they be sold.

It is further understood and I do agree that no monies or other consideration in any form, including reimbursement for any expenses incurred will become due to me, or those for whom I am the legal guardian, our heirs, agents, or assigns at any time because of our participation in any of the above activities.

Rustycon Privacy Statement

Your privacy is of great concern to Rustycon. The information we collect on this site is only used for its stated purpose. We do not sell or share any of the information we collect with any third parties. The information we collect is used in the following ways:

To create your Rustycon membership in our database.
To identify you when you come to collect your registration packet.
To contact you in case of emergency.
To analyze demographical information and adjust our focus and policies accordingly.
To provide legal authorities with information if required.
To ensure our compliance with laws applicable to the events we host.

This may not be a complete list of how we use your information. The point we want to get across is that we’re not going to abuse the trust you place in us. We will use the information responsibly, in ways that would not be considered offensive by most people.

If you choose to be on a mailing list, either paper or e-mail, you may rest assured that we will not sell your information, nor will be send you unsolicited commercial material. By choosing to be on the mailing list, you are soliciting Rustycon-related material from us.

In the course of registration, you may be redirected to PayPal’s website to complete your transaction. We suggest that you read PayPal’s privacy statement carefully, as we do not represent them, nor do they represent us.

Child Privacy Policy