REGISTRATION FORM - Chemically Dependent Anonymous

CHEMICALY DEPENDENT ANONYMOUS
th
Serenity Weekend’s 25 Anniversary - “Silver Linings”
May 1 - 3, 2015
Join us for a weekend of fun & fellowship at the Atlantic Sands Hotel in Rehoboth Beach, Delaware
Friday Afternoon
Saturday Morning
Sunday Morning
3:00 pm Registration
7:00 am Eye Opener Meeting
10:00 am Speakers Meeting
Saturday Evening
7:00 pm Speakers Meeting
8:00 am – 10:00 am Breakfast
10:00 am Speakers Meeting
All Weekend
Weekend and Marathon Meeting
Schedules will be available at the
Registration area
Friday Evening
7:30 pm Speakers Meeting
9:00 pm Entertainment - Marshall Manlove,
Comedy Hypnotist
9:00 pm Entertainment - 1980's Themed
Murder Mystery. 80's costume dress is
encouraged!
ACCOMMODATIONS: All Serenity Weekend events are held at the Atlantic Sands Hotel (800) 422-0600 Address: 101 N. Boardwalk, Rehoboth
Beach, DE 19971 (www.atlanticsandshotel.com). Make your room reservations directly with the Atlantic Sands Hotel. To guarantee the
discounted group rate, reservations MUST be made by March 11, 2015. Please be sure to reference Booking ID #7151 and Group Name
'CDA Serenity Weekend.' There is a two-night stay requirement: Friday-Saturday or Saturday-Sunday. Room Rates Per Night: Single/Double
Occupancy $130.00; Triple Occupancy $145.00; Quad Occupancy $160.00. Specific room requests are subject to availability at check-in. For
more information contact Ginny Bonanno (240) 429-8449 Email: ginnybonanno@gmail.com OR Larry Larimore (301) 332-2832.
REGISTRATION FORM - MAIL BY MARCH 31, 2015
First Name
Last Name
Street
City
State
Home Phone
Zip Code
Cell Phone
Email:
List additional attendees on the back of the form
REGISTRATION FEE: $65.00 non refundable, per person registration fee includes all Weekend Activities and Entertainment. No partial
registrations. Hotel room costs are separate.
Number of Attendees
x $65.00 = $
SCHOLARSHIP REQUEST: If you are requesting a scholarship, please be sure to complete the contact information section above. If awarded
registration and/or room scholarship, you may be asked to do service work throughout the weekend. If awarded a hotel room, you will be
rooming with 3 other scholarship recipients.
`
Registration Fee Only
`
`
Room Only
`
Registration & Room
Other: I can afford to pay a partial amount towards registration
and/or a room
$
SUNDAY BREAKFAST BUFFET: The buffet is included in the registration fee. A separate fee is required for children over 5 yrs old. Please
indicate below the number of breakfast attendees with/without paid registration.
Total
No. of Attendees Cost Each
Adults with paid registration
Children 5 years and under
Children 6 to 9 years old ($5 each)
Children 10 years and older ($10 each)
No charge
No charge
x $5.00 $
x $10.00 = $
Total Amount Breakfast
$
T-SHIRTS: Pre ordered Serenity Weekend t-shirts will be available for pick up at the Registration Area. Indicate the number of t-shirts wanted
under the size desired below.
SM
MED
LRG
XL
XXL
Short Sleeve
Long Sleeve
XXXL
Total Qty
Cost Each
x $15.00 = $
x $20.00 = $
Total Amount T-shirts $
Total
SCHOLARSHIP FUND DONATION: Scholarship fund donations will go toward registration and/or room scholarships to CDA Fellows who
otherwise may not be able to attend Serenity Weekend.
Donation Amount $
Make Checks Payable to CDA and mail by March 31, 2015 to:
Ginny Bonanno
1734 Gunwood Place
Crofton, MD 21114
TOTAL AMOUNT ENCLOSED $