PYM March 2010 Sessions Registration Survey

Registration Form for Adults and Children

Welcome! We are so happy that you will be joining us for March Sessions at the Arch Street Meeting House!

This form can be used to register ADULTS and CHILDREN (ages babies through 5th grade).

MIDDLE SCHOOL FRIENDS and YOUNG FRIENDS registration materials are available from a link at www.pym.org/annualsessions.

Please Note: For adults and children (age 0-11), there is a charge for meals only; there is no registration fee. We cannot accept payment online - please plan to pay in person at March Sessions. THANK YOU!

1. For each adult you wish to register, please enter the first and last name as you would like the name to appear on the nametag ("Jon" instead of "Jonathan" for example)

For each adult you wish to register, please enter the first and last name as you would like the name to appear on the nametag ("Jon" instead of "Jonathan" for example) Adult #1 First Name:
Adult #1 Last Name:
Adult #2 First Name:
Adult #2 Last Name:

2. Are you interested in volunteering for any of the following roles?

	Usher	Registration	Tray Carrier	Children's Program	Library	As-Needed Helping Hand
Adult #1	*Are you interested in volunteering for any of the following roles? Adult #1 Usher	Adult #1 Registration	Adult #1 Tray Carrier	Adult #1 Children's Program	Adult #1 Library	Adult #1 As-Needed Helping Hand
Adult #2	Adult #2 Usher	Adult #2 Registration	Adult #2 Tray Carrier	Adult #2 Children's Program	Adult #2 Library	Adult #2 As-Needed Helping Hand

3. Young Adult Friends (YAF) between the ages of 18-35 will have several opportunities to gather informally together for fellowship and community building during March Sessions (follow the YAF link from www.pym.org/annualsessions for details).

Please let us know if you are a Young Adult Friend:

	Yes	No
Adult #1	*Young Adult Friends (YAF) between the ages of 18-35 will have several opportunities to gather informally together for fellowship and community building during March Sessions (follow the YAF link from www.pym.org/annualsessions for details). Please let us know if you are a Young Adult Friend: Adult #1 Yes	Adult #1 No
Adult #2	Adult #2 Yes	Adult #2 No

4. Children (babies through 5th grade) you wish to register:
Please list full name as you would like it listed on the nametag.
You will also need to complete a Children's Sessions Registration form available on www.pym.org/annualsessions. THIS IS AN IMPORTANT SAFETY ISSUE and children cannot be admitted to Children's Sessions without this form.

Children (babies through 5th grade) you wish to register: Please list full name as you would like it listed on the nametag. You will also need to complete a Children's Sessions Registration form available on www.pym.org/annualsessions. THIS IS AN IMPORTANT SAFETY ISSUE and children cannot be admitted to Children's Sessions without this form. Child #1 First Name:
Child #1 Last Name:
Child #1 grade:
Child #2 First Name:
Child #2 Last Name:
Child #2 grade:
Child #3 First Name:
Child #3 Last Name:
Child #3 grade:
Child #4 First Name:
Child #4 Last Name:
Child #4 grade:

5. Please indicate which meals each person will eat at Arch Street Meeting House
MEAL FEES:
Breakfast: $6 adults; $3 children
Lunch: $7 adults; $7 children
Dinner: $13 adults; $6.50 children

	Friday Dinner	Saturday Breakfast	Saturday Lunch	Saturday Dinner	Sunday Breakfast
Adult #1:	*Please indicate which meals each person will eat at Arch Street Meeting House MEAL FEES: Breakfast: $6 adults; $3 children Lunch: $7 adults; $7 children Dinner: $13 adults; $6.50 children Adult #1: Friday Dinner	Adult #1: Saturday Breakfast	Adult #1: Saturday Lunch	Adult #1: Saturday Dinner	Adult #1: Sunday Breakfast
Adult #2:	Adult #2: Friday Dinner	Adult #2: Saturday Breakfast	Adult #2: Saturday Lunch	Adult #2: Saturday Dinner	Adult #2: Sunday Breakfast
Child #1:	Child #1: Friday Dinner	Child #1: Saturday Breakfast	Child #1: Saturday Lunch	Child #1: Saturday Dinner	Child #1: Sunday Breakfast
Child #2:	Child #2: Friday Dinner	Child #2: Saturday Breakfast	Child #2: Saturday Lunch	Child #2: Saturday Dinner	Child #2: Sunday Breakfast
Child #3:	Child #3: Friday Dinner	Child #3: Saturday Breakfast	Child #3: Saturday Lunch	Child #3: Saturday Dinner	Child #3: Sunday Breakfast
Child #4:	Child #4: Friday Dinner	Child #4: Saturday Breakfast	Child #4: Saturday Lunch	Child #4: Saturday Dinner	Child #4: Sunday Breakfast

6. For each registrant, please let us know:
Is this the first time you have attended PYM Sessions?

	Yes	No
Adult #1:	*For each registrant, please let us know: Is this the first time you have attended PYM Sessions? Adult #1: Yes	Adult #1: No
Adult #2:	Adult #2: Yes	Adult #2: No
Child #1:	Child #1: Yes	Child #1: No
Child #2:	Child #2: Yes	Child #2: No
Child #3:	Child #3: Yes	Child #3: No
Child #4:	Child #4: Yes	Child #4: No

7. Do any of the individuals you are registering have special accessibility needs (ASL interpretation, etc.)? If yes, please specify:

Do any of the individuals you are registering have special accessibility needs (ASL interpretation, etc.)? If yes, please specify: Adult #1:
Adult #2:
Child #1:
Child #2:
Child #3:
Child #4:

8. Contact Information - please provide the details necessary for us to contact you.

Contact Information - please provide the details necessary for us to contact you. Home Phone
Cell Phone (if any)
Email Address
Meeting/Affiliation
Street address IF you do NOT have email

9. Any other comments regarding survey or questions that you have?

Any other comments regarding survey or questions that you have?

Thank you for registering, we look forward to seeing you at March Sessions.

When you click the DONE button, you will be directed to the PYM Sessions page. On this page you can find information about housing at Pendle Hill and the Holiday Inn as well as information on the Sessions Agenda and Programs.

PYM March 2010 Sessions Registration