Dates: Friday Evening, July 20, to Sunday Morning, July 22 (We can check in to our cabins after 4:00 PM Friday and must check out of the cabins by 10:00 AM Sunday.)

Place: YMCA Camp - Kalamazoo, MI. This is a barrack-type cabin. Bring your own bedding and towels. Dining room is air-conditioned, and meals will be prepared for us by the camp staff. Setting includes a large beautiful lake and a swimming pool.

Cost: $100.00 per person to cover meals and lodging ($50.00 for students and low income) - includes the five meals, lodging and program, plus recreation facilities (swimming pool and canoes). Any payment above $100 would be a much appreciated tax-deductible donation to DGH.

Dress: Very casual. Don't forget your swimsuit if you enjoy swimming!

Please print out this form, fill it out and include it with your payment. Register as soon as possible. Registration must be received by Friday, July 6. Make checks payable to Doctors for Global Health, and indicate on the check that it is for the General Assembly registration, and for whom. Send registration to DGH, P.O. Box 1761, Decatur, GA 30031.

Name(s):
Address:
Phone (home):
Phone (work):
Email (if applicable):
Title/Position:
Institution/Affiliation:
Flight or Bus Line, Number and Arrival Time (we will provide several car pools from the airport and bus station; if you desire transportation to the camp, please let us know the details of your arrival below):
I am renting a car and am willing to pick-up others arriving at the same time: No Yes (If yes, please provide arrival information above)