18th SF International Marian Conference
July 2-4, 2010
Crowne Plaza Hotel Conference Center
1221 Chess Dr., Foster City, CA 94044 (800)456-4197
Print and US Mail, Fax or E-Mail to:

 ST. RAPHAEL MINISTRIES, INC.
P.0. B0X 160, Half Moon Bay, CA 94Ol9
E-Mail:  srm.inc@juno.com
INFORMATION OR REGISTRATION: 800-456-4197 . FAX 510-897-6725
REGISTRATION FORM
Please list each name as you wish them printed on name tags.
List all additional persons registering on form;

NAME ______________________________________________ (Please specify , "Y" for High School and "C"for Child)

ADDRESS___________________________________________ 1_________________________________________________

CITY _______________________STATE__________________ 2_________________________________________________

ZIP_________________PHONE________________________ E-Mail_____________________________________________
CONFERENCE REGISTRATION FEES ONLY:
(your canceled check will be your receipt)Cash_____ Check_____Credit Card_____Date____________
Adult 3 days                 $60 until 2/20           $75 until 4/30          $89 at the Door------------------------$__________
Married Couple 3 days  $105 until 2/20       $120 until 4/30        $135 at the Door----------------------$__________
Youth & Children:    $20 until 2/20     $25 until 4/30                       $30  at the Door---------------------$__________
Young Adults - Saturday   $35 until 4/30                                            $45 at the door---------------------$__________
Family 3 days (2 adults, 2 children under 18 Free)  $125 until 2/20   $140 until 4/30      $180 at the door$__________
One Day: Friday $35 ( ) ,   Saturday $ 49 ( )  Sunday $35  ( )  until 6/15   -    $55 Per day at the door-$__________

SPECIAL DISCOUNTED PACKAGE CROWNE PLAZA HOTEL OF FOSTER CITY
3 DAYS CONFERENCE REGISTRATION FEES, PLUS HOTEL 3 DAYS / 2 NIGHTS
Adult: (double occupancy):     $175 PER PERSON until 4/30                Later $195 -$__________
Adult (Single occupancy):          $265 until 4/30                                        Later  $285 -$__________
Married Couple:                            $295 until 4/30                                        Later  $315--$__________
Family:                                         $310  until 4/30                                          Later $325 --$__________
Donation to help others attend------------------------------------------------------------------------------------------$__________

Total Paid (Make checks payable to Saint Raphael Ministries)---------------------------$__________
I will pray one Rosary or other prayer daily for the success of the Conference ----------------- (   )

CHARGE: VISA  MC  DISCOVER  AMEX Card No._____________________________________
Exp. Date______________________Signature _______________________________________
You can FAX credit card registration to (510) 726-5394   or    E-Mail:  srm.inc@juno.com
For more information call 1(800)897-6725
Secured on line Registration straphaelministries.org