| WRW Registration
(Must be postmarked by the Registration Deadline) |
|
|---|---|
| Fill out this registration
form on the screen and print it out or print it out and fill it out by hand. |
|
| I cannot attend but please keep me on the mailing list | |
| YES NO |
Have you attended before? |
| YES NO |
Has your address changed since your last worksop? |
| YES NO |
Will you arrive in time for dinner Friday at 5:30pm?? |
| YES NO |
Are you willing to speak or lead a workshop? If yes please include your phone number below. |
| Name | |
| Address | |
| City/State/Zip | |
| phone | (optional) |
| Sobriety Date Al-Anon Date Other Date |
|
| Cabin Preferences |
Choose one: Smoking No Smoking Doesn't matter Choose one: Late Nite Early to Bed Doesn't matter |
| Special Needs: | |
| deposit $37.50 | $37.50 due on arrival (NOTE: your deposit is NON-REFUNDABLE) |
| full-paid $75.00 | $00 due on arrival |
| $.00 | OPTIONAL WRW Scholarship Donation |
| $.00 | TOTAL amount enclosed |
| Make check or money order
payable to and mail to: WRW 403 Tree Crossing Parkway Hoover, AL 35244 |
|