REGISTRATION FORM COMPLETE THIS FORM AND MAIL TO: ROCK MOUNTAIN GATHERING 160 STAYMAN DRIVE ROSWELL GA 30075 (Please Print Clearly) Name – Guest 1 ___________________________________AA____Al-Anon_____Alateen____ Name – Guest 2____________________________________AA____Al-Anon_____Alateen____ Address________________________________________________________________ City________________________________________State___________Zip_____________ Telephone (Home)______________________________Cell_______________________________ Email Address___________________________________________________________ Name on Badge Name on Badge Guest 1_______________________________________________ Hometown or Homegroup Guest 2_______________________________________________ Hometown or Homegroup Registration fee is $25.00 per person. Make your check payable to Rock Mountain Gathering My check in the amount of $______________ for _________people is enclosed. Place an X here if Guest 1 would like to read at a meeting_________________________ Place an X here if Guest 2 would like to read at a meeting________________________ RESERVATION DETAILS Place an X as to how you would prefer to receive your registration confirmation and room reservation instructions: Via Home Phone # _____________________Via Cell# ______________________ Via Email Address____________________________________________________ (Please Print Clearly) How many rooms will you need_______________Double_______________Single If you don’t need a room, but will attend, place an X here_______________________ How many in your party_______________________________________________ Arrival Date__________________Departure Date__________________________