Your Name:
 [First and Last]
Spouse's Name:
 [First and Last]
Street Address:
City:
State:
Country:
Zip Code/Postal Code:
Phone #:
 [xxx-xxx-xxxx]
E-mail Address:
Your Home Church:
 [Church, City, State]

Children
If bringing children that are not your own, please have their parent/guardian fill out a Health Form and mail into the office.
Download Health Form

First Name
 Last Name
 Gender
 Age
 Grade
[2012-2013 School Year]		 Birth Date
[MM/DD/YYYY]		 E-mail Address

Select a Week
Week One [July 22-July 28] Week Two [July 29-August 4]

This is my/our first time
Introducing Family:

Adult Housing
Please choose your top three housing choices:

Bauer Lodge - Suite [3 or more children only]
Bauer Lodge, Kern Lodge, or Roger Williams Inn [Regular Hotel Room]
House
    Meal Option:
Lawson Lodge
Lone Tree Lodge
Cabin
   Meal Option:
Campsite [Non-Electric]
   Meal Option:
Campsite [Electric]
   Meal Option:
   Type:
   RV Length [ft]: 

If my housing preferences are full, I am willing to...
Accept any accomodations Be on a waiting list

Billing Information
 Billing information is the same as registration [If so, ignore this section]

Name:
 [First and Last]
Street Address:
City:
State:
Country:
Zip Code/Postal Code:
Phone #:
 [xxx-xxx-xxxx]
E-mail Address:

Please list additional relatives that are registering at this time:
[Name & Relationship]

Any additional comments regarding your registration:

Registration Verification:

A NON-REFUNDABLE deposit of $50 per adult and $20 per child or $150 per family must be sent following your registration.

Please mail payments to:
Northern Pines of MN
PO Box 1864
Minnetonka, MN 55345

Please do not hesitate to contact us if you have any questions regarding your registration.
You can call Julie Jaderston @ 612-861-5100 or submit a question through our online web form available on our Contact Us page.

Balance of payments after deposit to hold accommodations: 50% is due on February 1st, and the remaining 50% is due On May 1st or as arranged with registrar, payable in checks in U.S. funds, payable to Northern Pines.
Cancellations: Cancellations occurring 14 days or less before the first day of a conference are charged 10% of total registration. This can be applied to the following year’s registration if desired.

Family Registration
If you have any questions, please do not hesitate to contact us or call 612-861-5100