Name __________________________________  Ph# ______________________

Address ________________________________          AGE LIMIT GUIDELINE: 

___________________________APT#_______           Any one under the age of 14 will

City______________________ZIP___________          be accompanied by an adult at the

Church Affilation (If any) ______________________    events. Any one under the age of

Check what day you plan to attend:                      18 years of age are required to have a

___ Friday and Saturday                                           guardian on the camp grounds.

___ Saturday Only [No discount on full price of event]

Please tell us of any special needs you have [Medical, Dietary and etc...]

________________________________________________________

________________________________________________________

________________________________________________________

VOLUNTEERS NEEDED

___ I want to volunteer to help at this event (Each volunteer needs to fill out a seperate registration form).

PAYMENT (Registration Price includes meals and housing)

Select your payment option:

___  $60 Adult (Before May 1, 2009)   ___ $40 Youth (Before May 1, 2009)      ___ I will pay $75 at the door

___ $30 Adult Partial Payment   ____$20 Youth Partial Payment 

(Make Partial Payments Before May 1, 2009)

HOUSING (Included in the price of the registration fee - no price reduction if it is declined))

Please select one:

___  I need housing [If you wish to be housed with a group or individual please specify below:

___ No housing needed

___ Please put my name and address in for CNY District Wesleyan promotional material

Highlight the registration form using the mouse.  Put your cursor just before the name, hold down the left mouse button and drag your mouse down until the entire form is highlighted.  Release the left mouse button and select "File" at the top of your screen, select "print" then select "selection" and then select the print button.  Fill out the form and mail the form and payment together to the address listed below.

DEADLINE FOR THE DISCOUNTED TICKETS IS MAY 1, 2009. AFTER THIS DATE IT IS $75.

Do you want promotional material sent to you?  YES