Registration

Here is the brochure which includes a registration form as found on the YMCA Camp Eberhart Website.  Below is a generic registration form in case you are unable to open the brochure file(which is an adobe pdf file)

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Teaching with Nature:

 A Conference for Teachers

Monday, October 19, 2009

Curing Nature Deficit Disorder

8:30 am to 3:30 pm

 

 REGISTRATION 

Use This form if you’re unable to open the conference brochure.

Name:________________________________________

School Name:________________________________________

School District::____________________________

 Mailing Address::________________________________________

City:______________________  State:    ____         Zip:_______

Contact Phone #:__________________________

Fax::________________________

E-Mail Address::________________________________________

Certified for subject/grade level(s)::________________________________________

 Please Indicate your preferences for workshops. We will make our best effort to meet your request.

The availability of popular workshops will be based on requests as they are received. (First received, first choice.)

 1st Choice:________________________________________

2nd Choice:________________________________________

3rd Choice:________________________________________

4th Choice:________________________________________

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EARLY BIRD REGISTRATION –  $15

Payment MUST be received by October 1,2009, to receive discount.

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REGULAR REGISTRATION – $25 

(must be received by Oct. 16, subject to first 300 registrants)   

FAX or EMAIL COMPLETED REGISTRATION FORM TO (269) 244-5000 or brad@campeberhart.com

PAYMENT

by Credit Card (Circle One):

 VISA     AmEx     Discover  MasterCard 

 Card Number::________________________________________

 Expires:______

 Signature (required):________________________________________

Security Code:______

by Check

If you are making payment by check or money order, MAKE PAYABLE TO:  YMCA Camp Eberhart

 SEND PAYMENTS and along with this completed registration form to:

Brad Codgell, Conference Coordinator

YMCA CAMP EBERHART• 10481 CAMP EBERHART ROAD, THREE RIVERS, MICHIGAN 49093

Phone: (269) 244-5125 • Fax: (269) 244-5000 • Toll Free: 1-888-YCAMPEB (1-888-922-6732)

Limited overnight accommodations available. Contact Brad at Camp.

VISIT https://teachingwithnature.wordpress.com/for up-to-date information on sessions.

 
 

 

 
 

 

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