Registration Form for Love and Kindness

REGISTRATION FORM

Print, fill-in,  and send to:

Overeaters Anonymous
PO Box 2407
Columbia, SC 29202

Name:   

                                                       
Address:    

                                                    
City, State, Zip

Phone:

Email:

Do you want to volunteer?

Want us to find you a roommate? Please list how many roommates you would like: 

 Do you have a roommate?: If so, name(s):

(Roommates need to register separately)_____________________

Please read before completing the form.
Please indicate your first, second and third room choice below and mail payment for your first choice to the address below with a check payable to OA. In the event you do not get your first choice, a refund of the difference will be waiting for you at the retreat. Please contact DJ at deigezoo@gmail.com (preferred) or 803-772-7999 with any questions or concerns.

__________ $ 108 Johnson Motel (linens included)
__________ $ 75 Pelham Motel
__________ $ 75 Hammond Motel
__________ $ 18 Bearden Dorm
__________ $ 18 Mitchell Dorm
__________ $ 18 Stucki Dorm
__________ $ 26 RV spot

Room price $ _____________

Registration: 

$ 60 early bird now – August 31, 2014
$ 80 regular September 1 - October 31, 2014
$ 100 late November 1 – December 5, 2014
**Registration includes 5 meals**
Registration $_______ + Room $_______ =
Total Due - $_______

Retreat Registration: Overeaters Anonymous
PO Box 2407, Columbia, SC 29202