Please fill in all information requested. For additional information, call DuBose at 931-924-2353 or dubose@blomand.net
Name Name preferred on badge Address City State Zip Parish City of Parish Home Phone Office Phone Email Address Number of Years Attending Conference Past President Keyman
Please reserve a room for me at DuBose (2 nights) - To be paid for at check-in Enter a number "1", "2", or "3" to indicate your accomodation preference: Claiborne Hall (dormitory, with hall bath, and linens, two nights - Single $76 - Double $52 + 5% tax) Old Cabins (per bed, two nights, with linens, maximum 14 per cabin - $26 + 5% tax) New Cabins (bunkbeds, two nights, with linens, maximum 24 per cabin - $40 + 5% tax) Motor Home ($25) / Tent Camping ($12) I'm staying in a double room at DuBose. My roommate will be: I don't have a roommate, please assign me one. I'm making my own reservation at
CONFERENCE FEES Registration (includes meals, does NOT include room - Room should be paid for at check-in.) $ 110 New Attendee $ 115 Prior to July 1 $ 125 After June 30 $ 135 Day of Registration
ACTIVITIES (Please Choose One - and please pay for golf and tennis with registration) Golf Tournament (includes 1 golf cart per 2 players) $45 Handicap or average score Age Must be preregistered and paid by July1 - Choose one: Sewanee Willowbrook Tennis Tournament $5 Fly Fishing Afternoon Speaker Panel Canoe Trip (pay at conference) Choir (I would like to participate in the choir) Tree Climbing Bluegrass Jam Barbeque Contest Fun Walk/Run Cycling Skeet Shooting (pay at club) Hike
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