Christian Chefs International Conference
Sign Up Form

* = Required Input Field

* Name(s)
* How many people are you signing up for?
* E-mail
* Address
* Phone Number
* Do you work in the food-service industry?
If not, please explain in "Comments" area below
Yes
No
* What is your accomodations preference?
Rates are per bed per night based on a 2-night stay
Click HERE for descriptions (opens in new window)
Pinehurst Inn $55 Queen
Pinehurst Inn $65 King
Pinehurst Inn $75 Suite /w King

Nice Cabin $55 Full-Bed (private)
Nice Cabin $30 Twin (shared)
Nice Cabin $20 Loft (shared)

Basic Cabin $45 Full (private)
Basic Cabin $40 Single (private)
Basic Cabin $30 Full (shared)
Basic Cabin $20 Single (shared)
Sleeping Bag on cabin floor

I do not need accomodations

* How flexible are you with your accomodations preference?
(Some selections may no longer be available)
* Sex
(for housing)
Male
Female
Married Couple
Multiple Guests
Please house me with
* Would you be interested in a ServSafe sanitation certification course Tuesday afternoon? Yes
No
What is Servsafe?
* Would you like to be listed in the retreat's address book to be given to all attendees? Yes
No
Comments:
What you would like to see, learn & do at this conference
so that we can know how to serve you better.

 

Can't afford this?
(Scholarships may be available)
Would you be interested in helping to sponsor someone in need?
Please PRINT this form before submitting.

Send a copy of it with a check/money Order
Payable to "Pinehurst Inn"

Christian Chefs Fellowship
c/o Ira Krizo
17250 Highway 66
Ashland, OR 97520

Call Ira at (541) 488-1002 first to confirm your lodging option

Payment
(Call first to confirm lodging option before sending payment)
Pre-Registration: = $70/person + lodging
(payment sent before September 1)

After September 1 = $75/person + lodging
(Call us to hold with a credit-card)


(Please print first for confirmation)