Registration FormILDF Retreat & Confernce"FULFILLED"
June 4th – 6th , 2010
The Christian Retreat Center World Outreach
1200 Glory Way Blvd.
Bradenton, Florida
Register 5 on-site attendees and yours is FREE!* Full Name: __________________________________________________________________________
Mailing Address: ______________________________________________________________________
City: _____________________________ State/Province: _______________Zip/Postal Code: ________
Country: _____________________________
Cell phone: (______) __________________ Home Phone: (______) _____________
Email: __________________________________________________________________
Church Dance Ministry/Community or Network Dance Ministry: _______________________________________________________________________________________________________
EMERGENCY CONTACT INFORMATION: Name: ___________________________________________________________________
Address: _____________________________________________ Phone: _____________________________________________
CONFERENCE FEES
1.Registration Fees (All fees listed in U.S. Funds.) Full 3 day conference fee includes double room, Saturday meals all day, conference workshops, beautiful grounds, free conference tee shirt and other amenities. Rates are per person. ROOMS DOUBLE OCCUPANCY.
Registration Fees (All fees listed in U.S. Funds.) Full 3 day conference fee includes double room, Saturday meals all day, conference workshops, beautiful grounds, free conference tee shirt and other amenities. Rates are per person. ROOMS DOUBLE OCCUPANCY.POSTMARKED & PAIDPLEASE CHECK APPROPRIATE REGISTRAION FEE:BEFORE/ON APRIL 16THAFTER APRIL 16TH
BEFORE/ON APRIL 16THAFTER APRIL 16THOn-Site Conference 3 Days per person (2 beds w/meals Sat.) $200.00 $225.00Off-Site Conference 3 Days (no room, no meals) pp $150.00 $175.00Friday evening only (no room, no meals) pp $40.00 $50.00Saturday ONLY All Day (no room, meals included) pp $100.00 $125.00 Please include payment with registration form $ ____________MEALS FOR SATURDAY: Yes No (You cannot add meals later they must be ordered at time of pre-registration)
Will you require a wheelchair or special medical attention: __________________________________________________________________
Cancellations/Changes and Refunds: There are no refunds for anyone at anytime for any reason. Registration fee is transferable but not refundable. Substitutions are allowed at no charge. AIRFARE AND GROUND TRANSPORTATION NOT INCLUDED.
PAYMENT METHOD Check or Money Order must be in U.S. funds payable to: ILDF There will be a $25.00 fee charged on checks returned by the bank due to insufficient funds. Registration confirmation and information will be emailed.
Please check appropriate box: Check Money Order
Please mail completed registration form. Please mail to:
Please mail to:Email: liturgicalfellowship@yahoo.com
Phone: 443-739-6672 The ILDF Retreat 2010
The ILDF Retreat 2010Website: www.ildf.org P.O. Box 32456
P.O. Box 32456We Accept Money Orders / Ministry - Business Checks and Personal Checks. Pikesville, Maryland 21282
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LIABILITY WAIVER
Very Important Read Carefully
I am aware and am in full agreement that neither I, nor family member (s), friends or associates will hold ILDF its directors, staff, other students, attendees, volunteers responsible for any injury, incident (s), or death due to my attendance, activity, participation or travel with the International Liturgical Dance Fellowship. We will not bring any legal action or lawsuit (s) of any kind for any reason at anytime against ILDF its directors, staff, other students, attendees, or volunteers whether in connection with loss or damage of property / person, any injury, incident (s), or death due to my attendance, activity, participation or travel with the International Liturgical Dance Fellowship.
Print & Sign___________________________________________________
Date: _________________________________
Legal Guardian (s) of Youth (print and sign)
(1)Legal custodial parent (s):
Legal custodial parent (s):____________________________________________________________
(2)Legal non-custodial parents (s):
Legal non-custodial parents (s):____________________________________________________________
Date: ________________________________________________________
Photo/Video Waiver
The International Liturgical Dance Fellowship would like to publicize information about our Academy, ministry events, dance training, or programs that are available, and we can do this through use of pictures or video.
I hereby give my consent for photographs and/or video to be used for promotional purposes and may be added to the photo gallery of the ILDF at anytime for any reason. I waive any and all right to payment (s) for use of my photographs, video, or likeness of me. I understand that this waiver does not expire.
Attendee’s Name:
____________________________________________________________
Print Name
____________________________________________________________
Signature above
______________________________
Date:
Parent or Legal Guardian (print & sign)
Date: ________________________________
MAIL TO:
ILDF Retreat & Conf 2010
P.O. Box 32456
Pikesville, Maryland 21282
Registration Form below or request a registration form via email.
Register early space is limited!
Bring EVERYONE
who needs to be "Fulfilled!"
(*closes airports are in Sarasota, Florida and Tampa, Florida)
*Sarasota airport is about 15 minutes away. Tampa airport is about 30 to 45 minutes away.
Please contact the airline of your choice to confirm distance to Bradenton, Florida.
(Airtran / Southwest)
