MARVA Marriage Encounter Registration Form


We want to attend a Marriage Encounter weekend on:

___ October 2 - 4, 2009 at Skycroft Conference Center, Middletown MD
$150 deposit at registration (final $235 due on the weekend)

Our registration fee of $_________ is enclosed
--or--
 we paid through Paypal online on ____ /____ /____.

Names
________________________________________
(and nicknames, if desired)
Address________________________________________
City/State/Zip________________________________________
Phone (____) ______________
Email address ________________________________________

Wedding date 		_____________________

No couple is excluded because of inability to pay. Marriage Encounter is available to all couples--even at our expense, if necessary. Contact the registration couple to make alternative financial arrangements.

How did you hear about Marriage Encounter?


Special accommodations/diet needs?


If sending a check, MAKE PAYABLE TO: MARVA MARRIAGE ENCOUNTER.

Mail this form and non-refundable registration fee to:
Ellen Leiserson and Paul Kaplan
10101 Governor Warfield Parkway, Apartment #124
Columbia, MD 21044
(410)772-0011, registration@marva-marriage-encounter.org