DB-SEED-2009

Taste and see the goodness of the Lord; blessed is he who hopes in God - Psalm 33:9

Registration
Đông Bắc SEED 2009
Mary Immaculate Center
300 Cherryville Road
Northampton, PA 18067

4:PM Aug. 28 - 2:PM Aug. 30, 2009

Documents:

Brochure Waiver Form Donation	List of attendees
Note: One registration per person, regardless of age

Last Name*:

First Name*:

Age*:

Status*:
Retreatant
Parent/Guardian
5-yr and younger

Gender*:
Female
Male

Name of Parent or Legal Guardian**
Or write: N/A if you are Parent or Legal Guardian

NOTE:
* Required
** At least one Parent or Legal Guardian must attend the retreat.

Parent/Guardian Last Name*

Parent/Guardian First Name*

Community*:

Email*:

Phone (Cell):

Phone (Home)*:

Send a note to the Registration Team:

NOTE:
Last day for registration/Hạn chót ghi danh: August 18, 2009

Please double check all information carefully before submitting.

If you need to change any above item after submitting your registration, please contact us by email (shown below), we will be happy to assist you. Do not register a second time.

	Fee:
	Must be paid in full when register
	Adult	$130
	14 -15 (as a retreatant)	$75
	6 - 13	$75
	5 and younger	FREE

Please send Waiver Form and check payable to:

Huong Dao
8464 Monarch Ct
Annandale, VA 22003

On Memo line please note attendee's name

Contact:
Van Nguyen (508) 963-7416 vanxnguyen@yahoo.com
Huong Dao (703) 913-9174 tiendao@cox.net