Draft 8/22/01 CCL Convention 2002 - Building Holy Families Draft 8/22/01 CCL Convention 2002 - Building Holy Families
Registration Form
Please read the REGISTRATION INSTRUCTIONS before completing the Registration Form.
LAST NAME: ______________________ HOME PHONE: (_____) _____-_______ WORK PHONE: (_____) _____-______
ADDRESS _______________________________________________________ CELL PHONE: (_____) _____-______
CITY:________________________________ STATE:_______ ZIP:______________ EMAIL:_____________________
HUSBAND: _______________________ Workshops A____ B____ C____ D____
WIFE: ____________________________ Workshops A____ B____ C____ D____
Children accompanying parents to the convention:
Age (More names? Please attach additional sheet.) If you will be arriving by air, do you need transportation to or from the airport?____ Registration: -- includes a $30 non-refundable deposit FULL convention attendance $95 family or $60 Individual ----- or ----- $____________ DAILY convention attendance $35 family or $25 Individual per day (Sun __ Mon __ Tue __ Wed __)
Lodging: -- 2 beds per room; max 4 per room (2 on floor); full convention: 3 nights (Sun-Tue) Number of rooms _____ Number of beds (1 or 2 per room): ___ x $11 x number of nights:____ = $_______ = Total Bed Fee = $___________ Number of beds + extra linen packages: ___ x $10 = $_______ = Total Linen Fee = $___________ Using Off-campus housing (Y / N)? ___ Where? ________________________________________ Child Care / Teen Activities: -- this amount must be included in pre payment Number of children 3 and older: ___ x $15 (no more than $75) Total Child Care = $___________ Meals: Sun evening meal through Wed lunch. Persons age 6 and older: ___ x $60 = Total Meal Fee = $___________ Please consider contributing to the scholarship fund Scholarship Fund = $____________ $20 discount for full conference postmarked by May 1, 2002 $ --__________ Make Checks payable to CCL 2002 and send to: TOTAL FEES = $____________ CCL 2002, c/o Tom and Beth Parks [501-631-2652] Enclosed (Reg + Child Care) = $____________ 1200 W. Cottonwood St [ccl2002@swbell.net] Balance (due at check-in) = $____________ Rogers, AR 72758-6339 (Please Read REGISTRATION INSTRUCTIONS to avoid any SURPRISE!) Special Needs: (dietary? handicapped?)
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