May 2013 - Seventh Day Baptist | General Conference of the United ...

PER DAY RATE How #
(3b) OFF CAMPUS many? days Rate Amount
PER DAY RATE How #
(3a) ON CAMPUS * many? days Rate Amount
16 The SR
Parking on Campus: Vehicles ____ x ____ x $5.00 = _______
•Adults (age 11 and up)
Registration, All Meals ____ x ____ x $37.00 = _______
[Circle days: M T W Th F Sa]
Registration, Lunch/Supper only ____ x ____ x $33.00 = _______
[Circle days: M T W Th F Sa]
Registration, No Meals ____ x ____ x $21.00 = _______
•Children (age 4-10)
Registration, All Meals ____ x ____ x $20.00 = _______
[Circle days: M T W Th F Sa]
Registration, Lunch/Supper only ____ x ____ x $17.00 = _______
[Circle days: M T W Th F Sa]
Registration, No Meals ____ x ____ x $10.00 = _______
•Children (3 and under) ____ x ____ x FREE
TOTAL (3b) ________
TOTALS
Parking on Campus: Vehicles ____ x ____ x FREE = _______
•Adults (age 11 and up)
Room (bed), All Meals ____ x ____ x $64.00 = _______
[Circle days: M T W Th F Sa]
Room (bed), Lunch/Supper only ____ x ____ x $58.00 = _______
[Circle days: M T W Th F Sa]
Room (bed), No Meals ____ x ____ x $47.00 = _______
•Children (age 4-10)
Room (bed), All Meals ____ x ____ x $34.29 = _______
[Circle days: M T W Th F Sa]
Room (bed), Lunch/Supper only ____ x ____ x $31.29 = _______
[Circle days: M T W Th F Sa]
Room (bed), No Meals ____ x ____ x $24.57 = _______
Room (floor), All Meals ____ x ____ x $18.00 = _______
[Circle days: M T W Th F Sa]
Room (floor), Lunch/Supper only ____ x ____ x $15.00 = _______
[Circle days: M T W Th F Sa]
Room (floor), No Meals ____ x ____ x $9.00 = _______
•Children (3 and under) ____ x ____ x FREE
Regis., Housing, Meals, etc = _________
*(On-campus rates incl. registration) TOTAL (3a) ________
Less amount prepaid = _________
(6) If housing off-campus, Location: ___________________ Phone: ___________________
Balance Due = _________
Checks to: “SDB Host Committee”
Send form to: Boulder SDB Church
6710 Arapahoe Rd
Boulder CO 80303
(registrar@seventhdaybaptist.org)
Jan Graffius (304) 641-7619
(7) Transportation assistance needed between (air) ___ (train) ___ (bus) ___
Colo. Springs and the campus.
Arrive: Air # _____ Bus # _____ Train # _____ ______ ______ (a.m.) _______________
date time
(p.m.) (Carrier)
Depart: Air # _____ Bus # _____ Train # _____ ______ ______ (a.m.) _______________
date time (p.m.)
Pick-up costs: One way ____ x $20/person = ______ Round trip ____ x $40/person = ______
As the parent of ______________________________ , I further agree
that my child is legally responsible to the undersigned sponsor, and that said
sponsor may also make any necessary decisions regarding medical services.
Expected Conduct document on p. 13
Parent ___________________________ Date: ______________
I/we, the undersigned, have read and do understand the “Expected Conduct
at General Conference.”
Signed ___________________________ Date: ______________
Sponsor ___________________________ Date: ______________
___________________________ Date: ______________
Youth ___________________________ Date: ______________
___________________________ Date: ______________