NOPBC 2005 Activities Preregistration
Mail to:
Sandy Taboada, NOPBC Preregistration
6960 South Fieldgate Court
Baton Rouge, Louisiana 70808-5455
Email: smerchant@vetmed.lsu.edu

Fees: $15, one adult, no children
$25 one adult, children * $35, two adults, children
Fee includes bag lunch and workshop materials

Adult Name(s). Please include first and last name of each adult and indicate if the adult is a parent, grandparent, blind parent, teacher, other relative, etc.
1._______________________________________________________________________
2._______________________________________________________________________
Address__________________________________________________________________
City__________________________State____________ZIP________________________
Telephone ( )_______________Email_______________________________________

Fee enclosed (make check payable to NOPBC) $______________
REMEMBER TO DEDUCT $5 IF YOU PREREGISTER BY JUNE 1

YES [ ] NO [ ] This is my first NFB National Convention.

The fee includes at-large membership in the NOPBC and it covers all NOPBC workshops as described under this year's theme of "In the Driver's Seat" 2005 convention article about NOPBC activities. It does NOT include the NFB Convention registration fee which is $15 per person (including children). This fee must be paid in person at the convention starting on Sunday, July 3, or at other designated times throughout the convention. It also does NOT include cost for childcare (NFB Camp). If childcare is desired during the convention, you must preregister with Carla McQuillan, NFB Camp coordinator, 5005 Main Street, Springfield, Oregon 97478; (541) 726-6924.

Yes, I would like to pre-order the new WHOZIT family T-shirt to be picked up at registration. (I will SAVE $2 per T-shirt if I pre-order!) T-shirts are $10 for all sizes except XXL - add $2. The color choice is white or blue. I am sending a check or money order (payable to NOPBC) for______ T-shirts at $10 per T-shirt (add $2 for XXL) for a total of _______ shirts. I will need the following size shirts - SPECIFY COLOR PER T-SHIRT. Sizes: Child S, M, or L OR Adult S, M, L, XL, or XXL ________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
CHILDREN
Please note, this is not a registration form for childcare. Childcare, called NFB Camp, is sponsored by the NFB and operated by Carla McQuillan. Children from ages six weeks to twelve years are eligible to attend NFB Camp and preregistration is required (see packet enclosed).
*****************
Will you be bringing children? [ ]YES [ ]NO [ ]Undecided
If yes or undecided, please fill out the form below. You may copy the form or add a sheet of paper if you need more space. Please include information helpful to volunteers who will be meeting your child for the first time. Example: Benny is fully sighted, has mild autism, wears a hearing aid in his left ear, and can talk but is shy with strangers. Example: Teri has ADHD, is partially sighted, wears glasses. Example: Mark is totally blind, loves to show off his Braille skills, is overly friendly and wants to hug everyone. Please note that some activities have age restrictions and some require that the child be accompanied by an adult. Activities for children/youth are for blind and sighted unless otherwise specified. We highly recommend that you preregister. We will try to include every child, but if we don't have enough space or materials, children who preregister are given priority.

Under Age 5:
Child's name_________________________________Birth date_______Male Female
Reading mode (Braille, print, large print) __________________________________________
Please describe your child's vision and any other information volunteers working with your child should know: ________________________________________________________________
___________________________________________________________________________
Saturday, July 2: [ ]YES [ ]NO My child will be with me in the morning session.
[ ]YES [ ]NO My child is preregistered for NFB Camp for all or half of the day.
[ ] 7:00 - 9:00 p.m. Family Scavenger Hunt - the WHOLE family (child must be accompanied by an adult)
Sunday, July 3
[ ] 9:00 - 10:30 a.m. Cane Walk (child must be accompanied by an adult)
[ ] 11:00 - 12:30 p.m. Cane Walk (child must be accompanied by an adult)

Child's name_________________________________Birth date_______Male Female
Reading mode (Braille, print, large print) __________________________________________
Please describe your child's vision and any other information volunteers working with your child should know: ________________________________________________________________
___________________________________________________________________________
Saturday, July 2: [ ]YES [ ]NO My child will be with me in the morning session.
[ ]YES [ ]NO My child is preregistered for NFB Camp for all or half of the day.
[ ] 7:00 - 9:00 p.m. Family Scavenger Hunt - the WHOLE family (child must be accompanied by an adult)
Sunday, July 3
[ ] 9:00 - 10:30 a.m. Cane Walk (child must be accompanied by an adult)
[ ] 11:00 - 12:30 p.m. Cane Walk (child must be accompanied by an adult)

Ages 5 - 11:
Child's name_________________________________Birth date_______Male Female
Reading mode (Braille, print, large print) __________________________________________
Please describe your child's vision and any other information volunteers working with your child should know: ________________________________________________________________
___________________________________________________________________________
Saturday, July 2: [ ]YES [ ]NO My child will be with me in the morning session.
[ ]YES [ ]NO My child is preregistered for NFB Camp for all or half of the day.
[ ] Braille Carnival/story time, 2:00 p.m. - 5:00 p.m. Volunteers (Carnival Buddies) will be assigned to supervise and care for children at the Carnival and to escort older children and youth to and from the carnival and the workshops listed below.
[ ] 7:00 - 9:00 p.m. Family Scavenger Hunt - the WHOLE family (child must be accompanied by an adult)
Sunday, July 3
[ ] 9:00 - 10:30 a.m. Cane Walk (child must be accompanied by an adult)
[ ] 11:00 - 12:30 p.m. Cane Walk (child must be accompanied by an adult)
Monday, July 4
[ ] 5:00 - 7:00 p.m. Braille Book Flea Market (child must be accompanied by an adult)
Tuesday evening, July 4
[ ] 6:30 - 8:00 p.m. Children Can Learn to Handle Emergencies (ages 5 - 9. Child must be accompanied by an adult)
[ ] 8:30 - 10:00 p.m. Children Can Learn to Handle Emergencies (ages 10/up. Child must be accompanied by an adult)
Wednesday, July 5
[ ] Afternoon -- Dr. Doolittle Comes to Louisville (off hotel grounds. Family activity.)
[ ] Evening -- Audio-Described Family Night at the Movies (child must be accompanied by an adult)

Ages 12 and Up:
Child's name_________________________________Birth date_______Male Female
Reading mode (Braille, print, large print) __________________________________________
Please describe your child's vision and any other information volunteers working with your child should know: ________________________________________________________________
___________________________________________________________________________
Saturday, July 2: [ ]YES [ ]NO My child will be with me in the morning session.
[ ] Braille Carnival/story time, 2:00 p.m. - 5:00 p.m. Volunteers (Carnival Buddies) will be assigned to supervise and to escort older children and youth to and from the carnival and the workshops listed below.
[ ] 2:00 - 2:45 p.m. So, You Think You Would Like to Run a Meeting?
[ ] 3:00 - 5:00 p.m. Art is for Everyone (limited to 10 students)
[ ] 3:30 - 5:00 p.m. Puzzles, Brain Teasers, and Fun Things to do with Math
[ ] 7:00 - 9:00 p.m. Family Scavenger Hunt - the WHOLE family (child must be accompanied by an adult)
Sunday, July 3
[ ] 9:00 - 10:30 a.m. Cane Walk (child must be accompanied by an adult)
[ ] 11:00 - 12:30 p.m. Cane Walk (child must be accompanied by an adult)
[ ] 1:00 - 5:00 p.m. Teen Get-Acquainted Party (age 12 and up)
Monday, July 4
[ ] 5:00 - 7:00 p.m. Braille Book Flea Market (child must be accompanied by an adult)
Tuesday evening, July 4
[ ] 8:30 - 10:00 p.m. Children Can Learn to Handle Emergencies (ages 10/up. Child must be accompanied by an adult)
Wednesday, July 5
[ ] Afternoon -- Dr. Doolittle Comes to Louisville (off hotel grounds. Family activity.)
[ ] Evening -- Audio-Described Family Night at the Movies (child must be accompanied by an adult)