The Chesapeake Men's Gathering™ 2009 Registration Form

Print and Complete this Form, Mail with Remittance to:

Primary Registrant's Name:_____________________________

Mailing Address ______________________________________

                       ______________________________________

Daytime telephone number (_____) _____________________

Evening telephone number (_____) _____________________

E-Mail Address______________________________________

Registrant 1:_______________________________/self,   Age ____, T size _____, $ _______

Registrant 2:____________________________________, Age ____, T size _____, $ _______

Registrant 3:____________________________________, Age ____, T size _____, $ _______

Registrant 4:____________________________________, Age ____, T size _____, $ _______

** Scholarship donation (help a man, teen, or boy)                                              $ _______

                                                                                          Registration TOTAL: $_______

First year at the Gap? Yes _______ No ________

How did you learn about us? ____________

Number of registrants requiring vegetarian entrees_____________________

Cabin Preference (is there someone you want to be in the same cabin with?)

____________________________________________________

Fees: for Chesapeake Men's Gathering 2009.
Postmarked By September 9^th:

Men (20+): $210

Teens and Boys (first youth): $130

Teens and Boys (additional youth): $65

Postmarked After September 9^th:

Men (20+): $225

Teens and Boys (first youth): $140

Teens and Boys (additional youth): $70

Tee-Shirts: Each Registrant Receives One Tee-Shirt

Men Sizes: S, M, L, XL, XXL, XXXL

Youth Sizes: Y-S (6-8), Y-M (10-12), Y-L (14-16)

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** The Men's Council of Greater Washington is a non-profit organization. Our tax id number is 52-1768294. Your gift is tax deductible but please consult your tax advisor for additional information.

Form Updated: 01-Sep-2009