Winter Peace Retreat -- Registration Form

Winter Peace Retreat at Spruce Lake
Peacemaking in Latin America
February 10-12, 2006 (Friday-Sunday)

Registration Form

Most rooms accomodate up to four people (a double bed and a bunk bed with private bath), and one or two additional family members may be accomodated in the same room on the floor if you wish to bring sleeping bags for them. Single adults who wish to room together should send in their registration forms together, otherwise they will be paired with other singles if space is limited.

Name__________________________________________________________________

Address_______________________________________________________________

City, State____________________________________________ZIP____________

Phone______________________________E-mail_____________________________

Children/Youth:         NAME                      AGE           GENDER

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________


____Adults @ 110.00 each*   ___________

____Children @ $27.00 each  ___________
 
____Youth @ $65.00 each     ___________ 

       (Additional donation ___________) 
     
                       TOTAL___________

             Amount Enclosed___________

     Amount Due at Check-in ___________

Cost to Participants:

$110.00 Adults
*($95.00 if paid by Jan. 5, 2006)

$27.00 Children (Ages 6-12)
$65.00 Youth (Ages 13-18)
Children under 6 are free!

Make checks payable to:   Eastern District Conference

Mail this registration form to:
     Becky Felton
     942 Camp Trail Road
     Quakertown, PA 18951 

Registration deadline is   January 18, 2006

Any questions?  Need more information?  
See http://efpjc.ppjr.org/efp062.htm, or
Call  Becky Felton, 215-536-7935,  E-mail: bfelton@netcarrier.com
  or  Robert Walden, 610-861-0653, E-mail: RWaldenPA@entermail.net