October 22 -24, 2010

Registration Form

Please use one form for each person attending
Registration Deadline: October 15, 2010

First Name:
Last Name:
Address:
City: State: Zip:
Phone:
E-mail:

Class of:

Options this year include an early arrival on Friday with several planned activities (check the SSCDA web site for more information).

Attendance Options:
I will be staying overnight at the retreat center
$180 - both nights   $90 - one night (specify: )

I will be a commuter from local motel or home
$120 - both days $55 - one day* (specify: )

$15 - I will attend the special Friday afternoon session*

*Note: if attending only Friday, the $55.00 rate will cover the afternoon session as well – Do not send additional $15.00 for the afternoon

If you do not plan on taking all meals at Stella Maris, please indicate those you expect to miss (Friday Dinner, Saturday Breakfast, Saturday Lunch, Saturday Dinner, Sunday Breakfast):

Special needs/dietary concerns:

I would like to help with:
Registration  Music  Liturgy  Hospitality  Anything I can to help

Total amount: $

If mailing registration, send with payment to:
St. Bernard's School of Theology and Ministry
Attn: Ellen Morningstar, Registrar
120 French Rd.
Rochester, NY 14618