City, State, Zip
Your Roommate's Name*
*We will place you with a roommate if none is specified.
Double-Shared bath $260.00 USD
Private-Shared bath $280.00 USD
Private-Private bath $300.00 USD
Cost in full is due with registration.
Sorry, No Refunds
If necessary you can print this form and mail it with a check payable to:
Journey To Freedom
24 Buena Vista Street, Unionville, CT 06085
( your canceled check will be your receipt )