Thursday, July 1
th
to Monday, July 5
th
, 2010
Registration fee (full retreat): $250
Partial attendance: $65 per day
Fees include accomodation, activities, meals, and local transportation.
Click here to visit the retreat web site for complete details.
Registration Information
[Fields with "*" are required]
LastName*
FirstName*
Parent's Name*
Permanent Address*
City*
State*
Zip*
Home Phone*
Cell Phone *
Date of Birth *
(MM-DD-YYYY)
Email (Camp Attendies's email)*
University/ Employer
Male
Female
Emergency Contact
Emergency Number
Tshirt Size
Small
Medium
Large
Extra Large
Camp Days
For 5-day attendees, this includes the Full Retreat $250
For 4-day attendees, this includes 3-night stay $250
For 3-day attendees, this includes 2-night stay $195
For 2-day attendees, this includes 1-night stay $130
For 1-day attendees, accommodation is not included $65
{Note: Cost of the camp includes food, lodging, and transportation as shown above}
The per day fees is $65 and full camp is $250
If NOT registering for full camp, please mention which night(s) you will require accommodation for in the
Additional Comments
section below
Medical Issues
[e.g. allergies, etc.]
Additional Comments
Transportation Information
Do you need transportation from Airport?
Please Enter
ARRIVAL
Information (If you need transportation)
Flight
Airport [O'Hare/Midway]
Date [mm/dd/yy]
Time [hh:mm]
Please Enter
DEPARTURE
Information
Flight
Airport [O'Hare/Midway]
Date [mm/dd/yy]
Time [hh:mm]
