INSTITUTE FOR SERVANT LEADERSHIP

Conference Dates: October 26-27 or

Doctrinal Track November 9-10

WHITEHALL CAMP AND CONFERENCE CENTER

 REGISTRATION FORM FOR A ROOM and/or MEALS

(Please complete one form for each participant)

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Name:______________________________________    Please circle one:       male                female

 

Address:____________________________________    Zip:  ___________   Email:_________________________________

 

___________________________________________    Phone #:______________ Church Name:______________________

Please circle one:     ISL (Oct 26-27)             Doc Track (Nov 9-10)              

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ROOM REGISTRATION

Please bring your own: sheets, a pillow case, blanket, a towel, a wash cloth and toiletries

(Room assignments are on a first received registration form basis—if a handicapped room is needed call Whitehall immediately to reserve one)

            _____ Thursday night $20.50          _____ Friday night $20.50    _____ Both nights $41.00                $ ____________

 

If you are sharing a multiple occupancy room, please write the name(s) of the other person(s) sharing the room with you.

 

NAME OF ROOMMATE(S):__________________________________________________________________________________

 

      _____ Thursday night $41.00             _____ Friday night $41.00    _____ Both nights $82.00               $ ____________

 

_____ Thursday night $35.25            _____ Friday night $ 35.25    _____ Both nights $70.50               $ ____________

 

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MEAL REGISTRATION

                                                                                    Number                           Amount        

Breakfast ----Friday ---- $4.50                                             _____                                    $ ____________

Lunch ------- Friday ---- $6.00                                             _____                                    $ ____________

Supper--------Friday ---- $7.00                                             _____                                    $ ____________

Breakfast ----Saturday - $4.50                                             _____                                    $ ____________

Lunch --------Saturday - $6.00                                             _____                                    $ ____________

 

                                                                                                                                                MEAL TOTAL =      $_____________

 

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GRAND TOTAL DUE FOR ROOM AND MEALS ......$_____________

 

Text Box: _____ check here if payment is being made by a church for a group of registrations

                                   Please send this completed form along with your check made out to “Whitehall Camp & Conference Center” to:

Whitehall Camp & Conference Center

ATTN: ISL/DOC Track

580 Whitehall Road

Emlenton, PA 16373

Room or Meal questions can be directed to:  724-867-6861 OR jill@whitehallcamp.org

 Forms can be FAXED TO: 724-867-0053

*ROOM AND MEAL REGISTRATION IS DUE TWO WEEKS BEFORE THE CONFERENCE*

Registration with Whitehall is VERY important so that meals can be planned properly!!