Register Today!

There are two ways to pay for the 2007 MOFAS -Teen Adult Conference

  • By Check - Fill out the form below, print it, click the "submit" button, and mail it in with your check contribution
  • By Credit Card (Visa, MC, AMEX, Discover) - Fill out the form below, click on the "pay by credit card" button, then click the "submit" button
2007
Life In The
FASLane

Teen / Adult
Conference

August, 3-6, 2007
 Register Today!
CAMPER ONE     Person with Diagnosis of FASD
First Name:
Last Name:
Hobbies/Work:
Address 1:
Address 2:
City:
State: Zip:

Home Phone:

  

Work Phone:

  

Email:

Special Diet

Special Medical Concerns

Permissions:

 Photos Video to MOFAS to use in publications

Age

             Gender  Male Female

Relationship to team member
  If you are a previous Minnesota Ward of State and
Adopted - you may qualify your team for a scholarship.
  Year Adopted   
Adoptive Parents Names
CAMPER TWO   Support Person
First Name:
Last Name:
Hobbies/Work:
Company:
Address 1:
Address 2:
City:
State: Zip:

Home Phone:

  

Work Phone:

  

Email:

Special Diet

Special Medical Concerns

Permissions:

 Photos Video to MOFAS to use in publications

Age

             Gender  Male Female

Relationship to team member

Professional Skills

   
 (Please list if you are a medical professional)
  Life guard certified
CPR certified
Other
   
   
   
Add Questions or Comments:
(Also please let us know if you have special physical needs)
 
I would like to include an additional camp donation.
      Click here to contact MOFAS.
 

When the form is completed click here and print a copy of the next page

Then return to this page to SUBMIT CAMP FEES - $350.00 per team
     Pay by Credit Card or
      send with copy of printed page with your check or money order to:
      MOFAS TEEN ADULT CAMP -
     1885 University Avenue, N 395 •
      St. Paul, Minnesota 55104

For more information, call:
Conference Coordinator:
 Cathy Callaway
952-431-6839
cathycallaway@yahoo.com

 


Minnesota Organization on Fetal Alcohol Syndrome
 1885 University Avenue, N 395 • St. Paul, Minnesota 55104
Toll-Free: 1-866-90-MOFAS (66327)
Phone: 651-917-2370 • Fax: 651-917-2405
 Contact MOFAS!

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Copyright © 2006 MOFAS. All rights reserved.

For more information, call:
Conference Coordinator:
 Cathy Callaway
952-431-6839
cathycallaway@yahoo.com

Special thank you to our Platinum Sponsor
Speckhard -Knight
Charitable Foundation

We need

  • Volunteer hours
  • Additional funding
     
  • Door Prizes
    • Household goods
    • Sports gear
    • Recreation items
    • Craft kits
  • Camp Bags or Backpacks
     
  • Snack foods
  • Beverages
     
  • Products to fill campers bags
    • Flashlights
    • Combs
    • Soap
    • Shampoo
    • Toothpaste
    • Cup holders
    • Travel mugs
    • Coffee mugs