St. Herman's West 2009 Registration Form

* Indicates Response Required

* First Name

* Last Name

* Street Address

Address Line 2

* City

* State/Province/Region

* Zip/Postal Code

* Country

* Phone Number

* Email Address

* Birth Date (mm/dd/yyyy)

* Sex

Male

Female

* Age

* Do you attend?

High School

College

What is your College Major?

Parish Information

* Parish Name

* City

* State/Province

* Parish Priest

Roommate Preference

Conference participants will be staying at the Best Western Sutter House hotel. Rooms will acomodate 4 people. Room occupancy will be assigned in to groups of college age and high school age participants. Please list your prefered roommates as per your group category. We will try to honor all roommate requests.

Roomate 1: Last Name

First Name

Roomate 2: Last Name

First Name

Roomate 2: Last Name

First Name

Roomate 3: Last Name

First Name

Roomate 4: Last Name

First Name

Transportation Information

* Do you require transportation to and from the airport?

YES

All flights must be to and from Sacramento International Airport (SMF). All participants from Canada must have passports

Arrival

Airline

Flight Number

Date(mm/dd/yy)

Time

am/pm

Departure

Airline

Flight Number

Date(mm/dd/yy)

Time

am/pm

Are you traveling in a group?

yes

How many in the group?

If you are travelling by bus you must depart and arrive in Santa Rosa. Please give us time of arrival/departure, date of arrival/departure, station.

Church Involvement

* Do you sing in your parish choir?

YES

If yes, what voice do you sing?

* Do you read at church services?

YES

I can read:

Do you serve as an altar boy/acolite in your parish?

YES

Payment Information

You may pay by credit/debit card through PAYPAL below:

Health form, gym release form, and Code of Conduct form must be signed and dated and brought with the participant to the conference and given to the conference organizers at the registration table when the participant arrives.
These forms can be downloaded at the REGISTER page of the St. Herman's West Conference web site

Please check box below and click continue in order to proceed to PayPal

* Conference Registration Fee
Online registrations will be subject to a $7 processing fee.

Registration Fee $257

* Indicates Response Required