Online Registration

Share the Care's 11th Annual Caregiver Forum
August 26th-28th, 2010

Rosen Shingle Creek Resort, 9939 Universal Boulevard, Orlando, FL 32819, 407-996-9939

Come ready to be renewed while you take a break from your daily caregiving duties. Enjoy 3 days and 2 nights of informative speakers, interactive breakout sessions, dining, entertainment, relaxation and celebration at our Timeless Elegance Gala on Friday evening. Overnight respite for your loved one may be provided at an assisted living facility, pending availability.

call Nikki Dixon at 407-423-5311 ext. 202

(entries marked with • are required)

Your Name (first,last)

•

Organization

Mailing Address

•

City,State & Zip

, •

Phone

Email: •

Reservations:

Level	Price	#	SubTotal

Total Charges:

Options:

Please enter this code:

•

... Processing, please wait ...

If there is a balance due, your credit card information will be taken by PayPal, the authorized online payment processor for Share The Care, Inc. and the trusted leader in online payments. You do not need a PayPal account to pay by credit card.

If you have problems using this form or have questions, please call 407-423-5311.