AMUUSE WEEKEND REGISTRATION
Print off the Registration Form below and mail it with the appropriate registration fee made
payable to AMUUSE to:

                   AMUUSE
                   Sharon Spencer, Registrar
                   336 Birchwood Court
                   Vernon Hills, IL 60061

Questions:  Contact Sharon at 847-816-3356; ssamuuse@aol.com

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                                         WEEKEND REGISTRATION FORM

Please check the box of the weekend you plan to attend:

□ March 16-17, 2012       □ May 4-6, 2012             □ November 9-11, 2012
   Saugatuck, MI                Yellow Springs, OH         Saugatuck, MI
   $145.00                         $70.00                        TBD
                                                                          Date not confirmed

If paying online: Amount Paid $_____________ Dated Paid ___________


__ Male ___ Female
Name _____________________________________________________________
Address ___________________________________________________________
City ___________________________ State _____ Zip _____
Email Address: ______________________________________________________
H Phone _______________ W Phone _______________ Cell ________________
Estimated Time of Arrival ______________ Vegetarian ______________________
Food allergies._______________________________________________________
Accessibility needs.___________________________________________________

I am interested in helping by DJing (at Saugatuck), leading a morning group, after-
noon activity, other _________________________________________________
_________________________________________________________________

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Please bring a snack to share with the group.

Registration begins at 5 pm
    Saugatuck operates on Chicago time (Central time). 
    Yellow Springs is on Eastern time.

Dinner is not served at the Saugatuck weekends. If you arrive around 5 pm, usually there will be individuals who will want to go out to eat together. If you are arriving later, you should
have dinner before you arrive.

A light dinner will be served at Yellow Springs.
Weekend Registrations