B2M Registration for Groups of Three or More

3+ Goup Registration Form

Please note that we request that large groups maintain a 1 adult per 5 student ratio. Please group students into workshops with this in mind. Thank you!

To register, please print this form and fax or mail to Boy to Men.

This form cannot be submitted electronically. It must be faxed or mailed.

Fax to: 207-221-0094.

Mail to: Boys to Men, 565 Congress Street, Suite 206A, Portland, Maine 04101

Registration deadline is Friday May 2, 2008

Registrant Number One:

Name
School
Age
Town
Email

Workshop Preferences
Please list 3 choices (by workshop number) in order of preference
for both morning and afternoon workshops.

Morning Workshop:

1.

2.

3.

Afternoon Workshop:

1.

2.

3.

Registrant Number Two:

Name
School
Age
Town
Email

Workshop Preferences
Please list 3 choices (by workshop number) in order of preference
for both morning and afternoon workshops.

Morning Workshop:

1.

2.

3.

Afternoon Workshop:

1.

2.

3.

Registrant Number Three:

Name
School
Age
Town
Email

Workshop Preferences
Please list 3 choices (by workshop number) in order of preference
for both morning and afternoon workshops.

Morning Workshop:

1.

2.

3.

Afternoon Workshop:

1.

2.

3.

Registrant Number Four:

Name
School
Age
Town
Email

Workshop Preferences
Please list 3 choices (by workshop number) in order of preference
for both morning and afternoon workshops.

Morning Workshop:

1.

2.

3.

Afternoon Workshop:

1.

2.

3.

Registrant Number Five:

Name
School
Age
Town
Email

Workshop Preferences
Please list 3 choices (by workshop number) in order of preference
for both morning and afternoon workshops.

Morning Workshop:

1.

2.

3.

Afternoon Workshop:

1.

2.

3.

Registrant Number Six:

Name
School
Age
Town
Email

Workshop Preferences
Please list 3 choices (by workshop number) in order of preference
for both morning and afternoon workshops.

Morning Workshop:

1.

2.

3.

Afternoon Workshop:

1.

2.

3.

Registrant Number Seven:

Name
School
Age
Town
Email

Workshop Preferences
Please list 3 choices (by workshop number) in order of preference
for both morning and afternoon workshops.

Morning Workshop:

1.

2.

3.

Afternoon Workshop:

1.

2.

3.

Registrant Number Eight:

Name
School
Age
Town
Email

Workshop Preferences
Please list 3 choices (by workshop number) in order of preference
for both morning and afternoon workshops.

Morning Workshop:

1.

2.

3.

Afternoon Workshop:

1.

2.

3.

Registrant Number Nine:

Name
School
Age
Town
Email

Workshop Preferences
Please list 3 choices (by workshop number) in order of preference
for both morning and afternoon workshops.

Morning Workshop:

1.

2.

3.

Afternoon Workshop:

1.

2.

3.

Registrant Number Ten:

Name
School
Age
Town
Email

Workshop Preferences
Please list 3 choices (by workshop number) in order of preference
for both morning and afternoon workshops.

Morning Workshop:

1.

2.

3.

Afternoon Workshop:

1.

2.

3.

If you are accompanying a child to the conference, please provide their name below.

Check here if you need interpreting assistance. Interpreting Services for the hearing impaired will be available.

Every effort will be made to enroll you in your first choice workshops. If workshops are filled, it may be necessary to assign a different workshop at our discretion. Workshops may be cancelled in situations of low enrollment.

By registering, you grant the Boys to Men Conference permission to use any photographic, motion pictures, recordings or any other record of this event for any legitimate purpose related to this conference.