2008 Teacher's Retreat - February 8-9

Please print registration form (one form per person) and fax to 863.696.1062
Only 175 tickets will be sold for this event.

If you prefer, you may fax your registration form to 863-696-1062 and pay on-line using our secure server.
(Just use the Registration box for fees to be paid)

Name__________________________________________________________________________ M or F

Address_______________________________________________________________________________

City______________________________________________________ Zip_____________________

Phone(s):______________________________________________________________________________

email:__________________________________________________________________________________

School:___________________________________ City:_________________________________________
Public/Private? _________________________ Grade(s) taught?___________________________
I have attended a previous Lake Aurora program? Yes or No

Cost : $65/ $60 if staying off campus Amount to be charged: _________
"First-timers" take $5 off.
Please add a 3% surcharge when paying with a corporate account card

Mastercard Visa

CC #_____________________________________________________________

exp. date:________ 3 digit extension code located on back of card:_____________

Printed cardholder's name:______________________________________________
Authorized signature:_________________________________________________

HOUSING - 175 beds are available for this retreat. Please state if your lodging will not be on campus.

I will be staying in: (Circle)

    Dorm/Cabin               Motel                    Other:__________
    _____Request "late night" dorm
    _____Request "need my rest" dorm
    _____I am physically UNABLE to sleep on a top bunk.

______ I have a diabetic need for sugar-free desserts.

Fax 863.696.1062 (Credit card payments)

A Confirmation ticket will be mailed to you if received before 2/2/08.

2008 Teacher's Retreat - February 8-9

Please print registration form (one form per person) and fax to 863.696.1062 Only 175 tickets will be sold for this event.

If you prefer, you may fax your registration form to 863-696-1062 and pay on-line using our secure server. (Just use the Registration box for fees to be paid)

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Please print registration form (one form per person) and fax to 863.696.1062
Only 175 tickets will be sold for this event.

If you prefer, you may fax your registration form to 863-696-1062 and pay on-line using our secure server.
(Just use the Registration box for fees to be paid)