Family Synergy - Conference 2002 Registration Form

Conference 2002 Registration Form

Family Synergy's
"Wild Wild West"
28th Annual
Conference and Reunion!
August 23-25, 2002

Each person or couple attending must complete a registration form

Registrant No. 1:

Name _____________________________________________________

Name you want on name tag __________________________________

Address ____________________________________________________

Home Telephone _____________ Work Telephone ______________

Family Synergy Member? YES _______ NO _______ All persons attending must be a member or in the process of becoming a member during the conference. All new members must attend a Provisional Member Orientation while attending conference

Registrant No. 2:

Name _____________________________________________________

Name you want on name tag __________________________________

Address ____________________________________________________

Home Telephone _____________ Work Telephone ______________

Family Synergy Member? YES _______ NO _______ All persons attending must be a member or in the process of becoming a member during the conference. All new members must attend a Provisional Member Orientation while attending conference

Conference price includes meals, entertainment and all workshops
for the entire weekend.

COST	OPTIONAL
[ ] Based on three persons per bedroom $610.00 per bedroom	[ ] Private swimming pool and spa Add $25.00
[ ] Based on two persons per bedroom $450.00 per bedroom	[ ] Private swimming pool and spa Add $25.00
[ ] Based on one person per bedroom $320.00 per bedroom	[ ] Private swimming pool and spa Add $25.00
(Call Pat for information on special pricing for singles to have room sharing options 760.243.4841 or email [email protected])

Co-Chair Pat Purcio 760.243.4841 or Dottie Trusty 714.901.5738
Email: [email protected]
Make checks payable to: Family Synergy
Print, fill out & mail this form to: Pat Purcio 15456 Little Beaver St. Victorville, CA 92392

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