Registration Form, Immersion Weekend 2010
Registration for Immersion Weekend 2010, Colorado Springs, CO, June 3-6, 2010
Ainm / Name _______________________________________________
Seòladh / Address _______________________________________________
Fòn / Phone _______________________________________________
Post-d / email _______________________________________________ (important)
Ainm Gàidhlig / Gaelic Name _______________________________________________ (optional)
Gnè / Gender _______________________________________________
Aois / Age (if under 18) _______________________________________________
Language Level _______________________________________________
ACGA Policy Students under 18 are welcome. However, if they intend to stay overnight, a parent pr parent-appointed guardian, must accompany them. Guardians must submit a signed parental agreement to that effect. Please email rudy@ramsisle.com to request a guardian form if registrant is under 18.
Weekend Fees (check one option only)
PR = tuition, private room (3 nights), meals (7)
T = tuition only
FM = (non-attending family member), accommodation, meals (8)
Includes Thursday Dinner through Sunday Breakfast
[ ] PR - $420.00 (pub dinner Thursday, optional lunch Sunday not included)
[ ] T - $200 (meals are available on a pay as you go basis $7 breakfast/$9 lunch /$12 dinner)
[ ] FM - $250 (includes double room plus meals)
Accommodation is private, lockable bedrooms in nice single-gender multi-student apartment units with large kitchen, living room, bathroom, shower. Fans, bed linens and towels provided. A limited number of entirely private apartments are available at higher cost. Please email rudy@ramsisle.com for details.
Special dietary requirements __________________________________________________________
Assisted access requirements __________________________________________________________
Parking required yes _______ no _______ (parking is free, but a parking pass is required)
Fee Total $_________________ (payable in U.S. dollars, or in Canadian dollars at par)
Late Fee ($50) $_________________ (after May 1)
ACGA dues ($35) $_________________ (if not already a 2010 ACGA member)
Tutor CD ($10) $_________________ (beginners - optional)
Donation $_________________ (tax deductible in US, as we're a 501c3)
Total $____________________
There is a $50 non-refundable cancellation fee.
If paying in U.S. funds, please make checks payable to "ACGA" and mail registration form and check to:
ACGA Immersion Weekend
c/o Rudy Ramsey, Registrar
7644 E. Lakecliff Way
Parker, CO 80134-5933
If paying in Canadian funds, make checks payable to "Toronto Gaelic Learners Association" and mail registration form and check to:
ACGA Immersion Weekend
c/o Janice Chan
43 Norbrook Crescent
Toronto ON M9V 4P7
