Restoring Balance: Building Peace through Right Relationships
September 17-20, 2009
Street Address or PO Box:______________________________________________________
City: _______________________________________ Phone:______________
| $ US
@ US$100/CAN$110 per person or US$4/CAN$5
per $1,000 of your income,whichever is higher: (US$110/CAN$120 after Aug. 1)
|____ Students/Low Income @ US$30/CAN$35 person: (US$35/CAN$40 person after Aug.1)||$_____||$_____|
|____ Daily Rate @ US$30/CAN$35 per person/day||$_____||$_____|
|____ Children under 12 @ $10/child||$_____||$_____
|____ I am unable to attend the Congress....|
|____ ...enclosed is my gift of||$_____||$_____|
|____ ...I will pray for the Congress|
| TOTAL ENCLOSED
I would like to stay:
____with a local host family (suggested donation: $5 per night). Home hospitality will be arranged for those who indicate this preference. Indicate the number of spaces required: ______
____on the floor (bring your own sleeping bag and mat).
(Note: the Congress will try to help with transportation coordination but will not make guarantees.)
____ I will be driving to Denver from ____________________________ and will have room for ____ extra passengers.
____ I would like to carpool with someone else who is driving.
____ I am
traveling by bus/train and need transportation to the Congress site.
Scheduled arrival: Date___________ Time_______
____ I will need transportation from the airport.
Airline________________ Flight #________
____ I will need help with childcare for ____ children, ages ________________.
____ I am willing to help with childcare.
____ I will need facilities to accommodate a physical disability as follows_____________________________________________________________.
need meals to accommodate the following dietary needs; list dietary need and number
of persons with this need:
Return completed registration form with a check in either $US or $CAN payable to:
CHRISTIAN PEACEMAKER TEAMS
Send to: PO Box 6508, Chicago IL 60680