IF YOU ARE PAYING BY CASH OR CHEQUE, PLEASE PRINT THIS FORM AND SEND WITH YOUR PAYMENT. Personal Information Full Name Diocese/Organization/Nation/Community Your Address Your Email Telephone Emergency Contact Name Telephone Special Requirements: please list any dietary, mobility, and health needs Food Allergies: For those living with food intolerances please bring what you need. The Centre is equipped with oven, microwave, fridge and freezer Would you like to receive Kateri Native Ministry emails or newsletters by email? YesNo Accommodations (Rooms are based on Double Occupancy, and are available on a first come, first serve basis) Please indicate your preferred roommate. This is not guaranteed, however we will make every effort to accommodate you. Check-in at Centre de l'Amour is on Friday, May 19th at 3:00pm. Dinner will be served at 5:00pm in the cafeteria.