Rest and Recharge Weekend Registration Form

Please fill out this registration form below and submit with your $200 deposit through PayPal

If you are mailing in your deposit payment, click here for printable form


Online Registration Form For Registrants using PayPal


Name


Address


Phone Number


Email Address

Accommodations: check your choice below

Double   Triple    Single

Roommate(s)?

 - Please list roommate name/s below

Check below if you would like to be matched up with a roommate

Yes, I would like to be matched up with a roommate

Please list any physical limitations in the box below:

Registration Deposit payment made through PayPal 
using the cart button at the top of this page: $200.00

       

If you are mailing a check or money order, please print and fill out the 
registration form below and send it, with your $300 deposit to:

Angelights
PO Box 7775
Cumberland, RI 02864 

To print - Highlight the registration form items below, click file>print and check "selection"

Registration For Rest and Recharge Weekend

 

Name          _______________________________________

Address      _______________________________________
                     
                  _____________________________________

Phone          _______________________________________

Email            ______________________________________
 
Accomodations:  Double______ Triple______ Single_______
 
Roommate(s) _______________________________________
                     ______________________________________
 
Want to be matched up with a roommate? _________________
 
Physical limitations___________________________________
 
Amount enclosed: Deposit of $200.00

 

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