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Friday, Jan 15th to Sunday, Jan 17th, 2010

(Cost for the Retreat is $100 full camp plus stay- or $60 per day* (For Friday or Saturday it includes overnight stay)
Full Conference: $100 (Includes 2 nights and 3 days starting Friday, Jan 15th)

*Daily Attendance: Friday, January 15 - $60 (accommodation is included)
Saturday, January 16 - $60 (accommodation is inlcuded)
Sunday, January 17 - $60 (accommodation is not included)

NOTE: Sunday night (Jan 17th) accommodation is not included. However, additional days stay available at the discounted rate payable directly to the hotel.

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* University/ Employer Male Female
Emergency Contact Emergency Number
Camp Days {Note: Cost of the camp includes food, lodging, and transportation.}
The per day fees is $60 and full camp is $100.
If registering for one day please mark the date in comments area
Medical Issues
[e.g. allergies, etc.]
Additional Information

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]