Our Whole Lives Registration form 2017

Our Whole Lives; K-1/4-6 Facilitator Training Registration

Trainers: Steve Caldwell and Ashley Johnson Important details about location, trainers, and required materials below.
Full Name*

First NameLast Name
Preferred Pronouns*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*

Area CodePhone Number
E-mail*
Emergency Contact; Name and Phone #*
Congregation (if applicable)
Referral Contact; Name and email
Minister or Religious Professional or Community Affiliation Referral
Community Affiliation (if not associated with the UUA/UCC)
Congregation or Community Affiliation City; State

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Dietary Accomodations

OmnivoreVegetarianVegan
Dietary Restrictions (please include any allergies or dietary restrictions
Housing Need

Prefer Home Hospitality provided by UUCLVPrefer Information about local hotelsSecuring my own accomodations
Registration fee is $275

On-line Payment Option below or Send Check payable to
Unitarian Universalist Congregation of Las Vegas
3616 East Lake Mead Boulevard, Las Vegas, NV 89115

Registration fees are due September 13, 2017

Required materials to purchase ahead of training: (available at uuabookstore.org)
*The fee includes registration, supplemental materials, light dinner on Friday, breakfast/lunch/dinner and snacks on Saturday, breakfast/lunch/snacks on Sunday, leaders’ fees, and administrative costs. Registration fees are refundable minus a $30 administrative charge and after all incurred expenses for the trainings are paid for.

For more information on our training space and congregation, visit www.uuclv.org
On-line Payment Option
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Our Whole Lives Training Registration Fee$275.00

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Our Whole Lives; K-1/4-6 Facilitator Training Registration