Full Name:
*
Age:
*
Birthday
*
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
1919
1918
1917
1916
1915
1914
1913
1912
1911
1910
1909
1908
1907
1906
1905
1904
1903
1902
1901
1900
Are you cosplaying?:
*
Yes
No
Please Note that the first 6 are only if you are NOT cosplaying, the following 6 are with the cosplay discount. We will not refund you the $5 at con for cosplaying. Please double check that you click the correct box before preceding.
Anime St. Louis 2010 Registration
Weekend Pass ($
25
)
Two Day Pass - Friday and Saturday ($
15
)
Two Day Pass - Saturday and Sunday ($
15
)
One day pass-Friday ($
15
)
One day Pass-Saturday ($
15
)
One day Pass-Sunday ($
15
)
Weekend Pass Cosplay discount ($
20
)
Friday/Saturday w/ cosplay discount ($
10
)
Saturday/Sunday w/ cosplay discount ($
10
)
Friday w/ cosplay discount ($
10
)
Saturday w/ cosplay discount ($
10
)
Sunday w/ cosplay discount ($
10
)
Total : $
0
COSPLAY DISCOUNT: Subtract $5 from total if you are cosplaying.
*IF YOU ARE NOT COSPLAYING WHEN YOU COLLECT THE BADGE YOU WILL NEED TO PAY THE EXTRA $5 TO RECEIVE IT*
Name on Badge:
*
Address:
*
City:
*
State:
*
Zipcode:
*
Phone Number:
*
E-mail address:
*
**Anime St. Louis reserves the right to revoke badges; pre-registration badges or at the door badges. Anime St. Louis also reserves the right to deny the cosplay discount for costumes that do NOT meet the qualifications as stated in our rules. Thank you**
Please note that the registration process is not completed until payment is sent and received.