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NA Convention Meals and Lodging Registration Form Cedar Lakes Conference Center HC 88 Box 21 Ripley WV 25271 304-372-7860 Date May 11 through May 13 2012 Cedar Lakes must have a form no phone calls will be accepted for reservations. Name Telephone Number Address City State Zip Email Address Email Sent Cedar Lakes will not be responsible for assigning roommates. If your roommate cancels you will be charged the total amount for the room and meal package. Rooms will be assigned on a first come first serve basis Packages include two nights lodging and 5 meals starting with Friday dinner through Sunday brunch. Holt Lodge Package Packages are 104. 70 per person two people per room* If there are three people in the room packages are 85. 26 per person* If there are four people in the room packages are 75. 56 per person* Private Double Triple Quad Mountaineer Package Mountaineer Lodge has 2 double beds in each motel* Packages are 83. 50 per person - two people in the room* If there are three people in the room packages are 71. 14 per person* If there are four people in the room packages are 64. 96 per person* Cedars Lakes Main Motel Package Cedars Lakes and Main Lodges have 2 twin beds in each motel* Packages are 82. 44 per person room* two people per Roommate Dorm Conversion Room Package There must be at least 4 people in each room* Cedar Lakes provides sheets and towels no maid service. 73. 96 per person Roommate s Names Dorm Room Package Each dorm has 10 beds to a room provides a pillow and a blanket. guest needs to bring towels washcloths sheets and pillowcase. Cedar Lakes 63. 78 per person Payment for the first night s lodging must be received at registration* Full payment must be received by April 11 2012 or your reservation will be cancelled* By submitting this form you give other arrangements are made. If paying by credit card Cedar Lakes accepts Visa Master Card and Discover and debit cards please circle below if it is a debit card or credit card. Debit or Credit Card Number Exp* Date Type of card Name on credit card Signature Owned by the WV State Board of Education and Operated by the West Virginia Department of Education. Name Telephone Number Address City State Zip Email Address Email Sent Cedar Lakes will not be responsible for assigning roommates. If your roommate cancels you will be charged the total amount for the room and meal package. Rooms will be assigned on a first come first serve basis Packages include two nights lodging and 5 meals starting with Friday dinner through Sunday brunch. If your roommate cancels you will be charged the total amount for the room and meal package. Rooms will be assigned on a first come first serve basis Packages include two nights lodging and 5 meals starting with Friday dinner through Sunday brunch. Holt Lodge Package Packages are 104. 70 per person two people per room* If there are three people in the room packages are 85. Holt Lodge Package Packages are 104. 70 per person two people per room* If there are three people in the room packages are 85. 26 per person* If there are four people in the room packages are 75. 56 per person* Private Double Triple Quad Mountaineer Package Mountaineer Lodge has 2 double beds in each motel* Packages are 83.

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