I am sending $ registration fee to register for the International Houseparty at Cedar Campus ($75) Balance is due upon arrival.

Male Female
First name: Family name:
Spouse's name (if attending):
Street :
City: State: Zip:
Phone: The best time to call me is:
email:
College:
Field of Study:
Homeland:
Special Dietary Needs (Please specify):
Religious background:

These children are coming with us:
Name: Age as of January 2009: Grade: Male Female
Name: Age as of January 2009: Grade: Male Female
Name: Age as of January 2009: Grade: Male Female
Name: Age as of January 2009: Grade: Male Female
In case of emergency, notify:
Phone in emergency (include Area Code):

I need a ride to Cedar Campus
I have a ride to Cedar Campus
I can take other people to Cedar Campus   How many?
I need to be picked up at the bus stop or airport in

A limited number of $75 scholarships for singles and $150 scholarships for families are available. Additional scholarships may be requested for families.

I need a scholarship to attend the Houseparty. Please send me an application form.
I do not need a scholarship.

In consideration for being accepted and allowed to participate in this conference/project and activities associated with its program and location, I (and my spouse) personally assume responsibility for my/our actions, and release InterVarsity Christian Fellowship/USA™ (hereafter InterVarsity), its Trustees, employees and agents from loss, injury or damage to myself or my property; provided that nothing contained herein shall excuse InterVarsity, its Trustees, employees or agents from responsibility to act with reasonable care for the safety of myself or my property. Should any dispute or controversy arise, I agree to seek resolution according to biblical principles through the Institute for Christian Conciliation. I give permission to InterVarsity to be photographed, recorded, and/or video taped and to allow this material to be used for publicity. I give permission to InterVarsity to obtain medical assistance in the event of an emergency. I release and discharge InterVarsity, its trustees, employees, and agents from any liability for any first aid rendered or treatment performed pursuant to this consent. I certify that I am at least 18 years of age (19 in Alabama) and that submitting this registration constitutes my agreement to these conditions.