MAY 18-20, 2012
City, State and Zip Code__________________________________________
Emergency Contact Name________________________Phone____________
_____$454 for Three nights with meals-Single occupancy
_____ $280 for Three Nights and Meals-Double Occupancy
_____ $375 for Two Nights and Meals-Single Occupancy
_____ $240 for Two Nights and Meals-Double Occupancy
Please list any food allergies___________________________________________________________
A deposit of $100 must accompany your registration. Balance of fees must be paid no later than February 15, 2012.
Mail your payment and this form to:
N4625 Old Forest Rd.
Cambridge, WI 53523
Confirmation will be sent via e-mail. If you do not have an e-mail address and want confirmation of payment, please send a self-addressed stamped envelope.