Registration Form

To register, please print and fill up this form. Make your cheque
payable to ”CJM-NENCC”, and send it with your registration to:

Name: __________________________________________________________

Address:_________________________________________________________

Phone:_____________________________________

Names of Children:                                      Age          Sex

Amount Enclosed:  $________________

For Part-time Participants and Day Guests:

ARRIVAL ON:______________________________
LEAVING ON:______________________________

MEAL & OVERNIGHT (Please check where needed)

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