Please reserve space in: (Please check one.)

o cabins   o local motel   o camping at conference grounds

o Super 8 Motel   o I will be making my own reservations.

 

Name:_______________________________________________

 

Address:_____________________________________________

 

       ________________________________________________

 

Phone:______________________________________________

 

Please list the names of everyone in your party and include the ages of all children (at conference time).

 

____________________________________________________

 

____________________________________________________

 

____________________________________________________

 

Please specify whether you are staying for all or part of the conference. If you are staying for only part of the conference, please specify when you will be arriving and leaving.

 

____________________________________________________

 

Total number of adults _____

 

Total number of children aged 3-12. ________

 

Total number of children under 3. ________

 

Meal tickets will be distributed at registration. Payment for both rooms and meals may be made when you check out.

 

Please mail this form, along with a $25.00/person non-refundable deposit, to Conference Reservations, 743 Ridge Road, Fallentimber, PA 16639. Make checks payable to Grace Alive Ministries.