2011 CRN Family Conference Online Registration

First Name*
Last Name*
Address Line 1*
Address Line 2
City
State
Zipcode
Phone
Email*
Date arriving at Hotel Nikko
Date departing Hotel Nikko
Attendee Names (Please list all)
Adult or Child
Childcare required? (Ages 1-12 only) Y/N
Child’s Age/Gender
Affected by cystinosis? Y/N
	T-Shirt Size Child “C” Small, Medium, Large Adult “A” Small, Medium, Large, XL, XXL, XXXL
T-Shirt Size

Payments can be made directly online using our link here to Paypal

Registration Fee (includes reception, 2 breakfasts, 2 lunches, and 1 dinner)

Early bird registration fee (before June 1st): $50 per individual or household

Registration fee (after June 1st): $75 per individual or household

Conference Sponsorship (tax-deductible)

It is our goal and our hope to support the conference in its entirety through sponsorship funding and donations. Falling short of our $150,000 goal would require utilizing general CRN funds, leaving shortages elsewhere. Please consider making an additional monetary donation towards the conference.