New Years Gathering 2015

Your Name *

Email Address *

Phone (home or mobile, or both)

Address

Registration Details: Please indicate how many of each accommodation choice below. 🛈

	Adults in Hotel Style Rooms ($360)
	Children (3-12) in Hotel Style Rooms ($160)
	Teens (over 12) in Hotel Style Rooms ($180)
	Adults in Bunk Rooms ($330)
	Children (3-12) Bunk Rooms ($145)
	Teens (over 12) in Bunk Rooms ($165)
	Adults Camping ($310)
	Children Camping ($135)
	Teens Camping ($155)
	Child under 3 -- Free

I am including a donation. 🛈

Please enter the names and ages of any children or teens coming with you (to help us arrange childcare.)

Any comments or questions? Room preferences? Special dietary needs? A program you'd like to offer, or like to propose?

How will you be paying? Your total will come up on the next screen, and then you'll need to pay by one of the options below. *

Direct Deposit to: AM Retreats, MCU, BSB 704 606, Acc No: 200115457

Direct Deposit to SDM, NAB Bank, BSB: 082 906, Account No: 193 462 913 (if a national bank is easier)

Check mailed to: AM Retreats, PO Box 177, Maleny 4552. Made out to SDM.

I'll pay at the door. ($20 extra per adult, $10 extra per child)

Other: Other: