Registration Form for
2002 - "Reaching for the Stars"
Kennedy's Disease
Association Conference and Symposium
Please print this form out, fill it out completely and mail with your conference
registration fees to:
Kennedy's Disease Association
P.O.
Box 1105, Coarsegold, CA 93614-1105 (U.S.A.)
(559) 658-5950 email:
info@kennedysdisease.org
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This registration form does NOT register you for your hotel
accommodations at the BWI Airport
Marriott. You must make these arrangements yourself. Here
is the information:
Cost per night: $159.00 + tax - Rooms
guaranteed at this special conference price only until
September 12, 2002 - You must mention that you are attending the
KDA Meeting to get this
discounted rate - Make your hotel reservations now!!!
Space is limited.
Hotel Reservation Lines: Toll-Free: 1-800-228-9290
or Direct: 1-410-859-8300
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Names of Attendees as you would like E-mail
Type of Attendee:
KD Individual or
them written on name
badges: Addresses:
Carrier? Family Member? Other?
_________________________________ ________________ _____________________________
_________________________________ ________________ _____________________________
_________________________________ ________________ _____________________________
_________________________________ ________________ _____________________________
Where should we send your meeting confirmation and information packet:
Mailing Address:___________________________________________________________
City:____________________________________________ State:____________________
Zip Code:_____________________________ Phone Number:
(______)_______________
We (do________) (do not_________) plan to go to the dinner Sunday
night at Gunning's Crab
House. We understand the cost of this dinner is NOT
included in our registration fees.
How many in your party are going to Sunday dinner at Gunning's Crab House: ___________
Number of Attendees: ______ x $125.00 (if registration
prior to August 15, 2002) = $________
______ x $150.00 (if registration on or after August 15, 2002) = $________
I would like to also include a donation at this time in the amount
of:
$________
Total Amount
Enclosed:
$___________
Please note, there are no refunds of
registration fees.
