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Friday, Jan 13th to Sunday, Jan 15th, 2012

Registration fee (full retreat): $125/person (Quad Occupancy)/ $150/person (Double Occupancy)
Partial attendance: $70 per day (Doesn't include accomodation)
 Fees include accomodation, activities, meals, and local transportation.

Click here to visit the retreat web site for complete details.

Registration Information
[Fields with "*" are required]

LastName* FirstName*
Parent's Name*
Permanent Address*
City* State* Zip*
Home Phone* Cell Phone * Date of Birth *     (MM-DD-YYYY)
Email (Camp Attendies's email)* University/ Employer Male Female
Emergency Contact Emergency Number
Camp Days {Note: Cost of the full retreat includes food, lodging, and transportation as shown above}
The per day fees is $70 and full retreat is $125(Quad)/person/$150(Double)/person
If NOT registering for full retreat, please mention which day(s) you will be attending in the Additional Comments section below
Medical Issues
[e.g. allergies, etc.]
Additional Comments

Transportation Information
(If the information for transportation can not be provided now, PLEASE Email: chykchicago "at" gmail "dot" com" with the details or call the coordinators)

Do you need transportation from Airport?
Please Enter ARRIVAL Information (If you need transportation)
Flight Airport [O'Hare/Midway]
Date [mm/dd/yy] Time [hh:mm]

Please Enter DEPARTURE Information
Flight Airport [O'Hare/Midway]
Date [mm/dd/yy] Time [hh:mm]