Please complete this form and  return it by July 20 to Andrea Holveck at 2007 47^th St., Des Moines IA 50310 or send all indicated information to  jackholveck@earthlink.net

 Early registration helps us with housing and meal planning.

Name(s)________________________________________________

Number of adults____ Young Friends ____ Junior Yearly Meeting ____ Pre-schoolers_____

Names and ages of youth attending Young Friends or Junior Yearly Meeting

______________________________________________________________________________

Date of arrival _______________Date of departure ______________ Home phone ___________

Where do you plan to stay?  (circle)

Camping at Scattergood                  Dorm room (how many rooms, 3 beds per room) ______

Motel                                                                                                     Friend in the area.  Who? _________________________________

Special needs __________________________________________________________________

When do you need childcare for preschool child? ______________________________________

Will you need a highchair? _____ Number of vegetarians _______ Number of vegans ________