Lakeshore Retreat
October 10-12, 2008
Millersylvania State Park, Washington
MAIL: P.O. Box 112096, Tacoma, WA 98409-2096
PHONE: (253) 279-7816
EMAIL:lkshoreretreat@aol.com
TO REGISTER:
* Print the form below, complete it,
and snail-mail to the address above.
* Please write clearly and complete a form
for each registrant.
* Include your check/money order for $70.
* Make check/money order payable to Lakeshore Retreat.
* Partial scholarships are available on a limited basis.
Email us for more information.
Your $70 registration fee includes:
* Five meals (Friday dinner, Saturday breakfast,
lunch and dinner and Sunday breakfast)
* Lodging accommodations in 8-person bunkhouses
* All workshops, speaker meetings and planned activities
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Name__________________________________________
Address_________________________________________
City____________________State/Prov._____________
Country___________Zip/Postal Code_______________
____ I require wheelchair access or have limited mobility.
____ I have other special needs (please list).
Daytime Phone___________________________________
Evening phone___________________________________
E-mail__________________________________________
Fellowship: (circle one) AA Al-Anon
Recovery Date (optional)________________________
Your name as you want it to appear on your badge:
We will make every attempt to accommodate groups
who wish to share cabins. To facilitate this, please
list the names of people you are traveling with;
last names will be helpful to avoid confusion.
If possible, send in your registrations together.
Name____________________________________________
Name____________________________________________
Name____________________________________________
Name____________________________________________
$ MY PAYMENT
____ DONATION TO FUND SCHOLARSHIPS
____TOTAL ENCLOSED
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We will acknowledge (by email if possible) receipt of
registrations received by the deadline of September 1,2007
Your confirmation will include further information and
suggestions to make this retreat a success for you.
