REGISTRATION | The Compassionate Friends East of The River CT Chapter

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“ALAN PEDERSEN EVENT”

UPDATE MAY 10 –
Walk-ins will be Welcomed
Lunch will still be included for walkins
Though Welcome Gifts and the Slideshow Photos will not be available

Funds to Contribute or Not, You Are Welcome!

space limited to the first 30 registrants

REGISTER NOW!
Don’t be Left Out!

EVERYONE IS WELCOMED TO ATTEND
WHETHER OR NOT THEY HAVE
THE ABILITY TO CONTRIBUTE

if you wish to make a donation
or financial contribution,
know that it will go directly to assist this ChapterÂ

There Is No Magic Wand .
We Know That We Cannot â€œHealâ€ YouÂ
Or â€œFixâ€ Your Reality.Â
We do want to help provide the resourcesÂ
for you to find your most healing path,Â possible.Â

Please Register each person in your group separately.Â
Once you have registered you will be taken to a PayPal link for a possible donation option.
Direct any questions, comments or concerns to Bettie-Jeanne at
TCFEastOfTheRiverCT@gmail.com
or send a Private Message through Facebook
to Bettie-Jeanne Rivard-Darby.Â
Thank You !

First Name *

(Please add your name as you prefer to be called. Register each participant separately)

Last Name *

Address *

City, State, Zip *

Phone Number *

Mobile Phone Number

Email Address *

Name on Facebook

"OTHER"

Name(s) of who you are attending in memory of and relationship, please.

example: RobynApril, my daughter + Janet, my sister + Punkins, my Brother + Joey, my Brother

TCF Chapter Affiliation (if any) or name and location of Support Groups you are / have attended *

How did you hear about this event? *

Just let us know how you found out

PAYMENT INFORMATION. SCHOLARSHIP NEEDED? Are You Planning To Apply for A Full Or Partial Scholarship? YOU DO NOT HAVE TO PROVE INCOME. WHATEVER INFORMATION YOU SHARE IS COMPLETELY CONFIDENTIAL *

Yes, I Really Need A Full Scholarship - I can't attend without it

Yes, I could Use a Partial Scholarship -I can contribute something - just not the full amount

No, Thank You - I will be paying the full amount

I am Willing to Make A Donation To Assist Others Who Can Not Otherwise Afford to Attend (you will be contacted by a Committee Member)

I will be paying by mailed check, before May 5, to TCF EOTR Angels PO Box 126 Manchester, CT 06045-0126

I will be paying on line -through PayPal - Today

I PROMISE to bring the fee on the day of the Workshop. I won't break my PROMISE, understanding that you are trusting me.

I need to make the payment after May 5 and will send email to TCFEastOfTheRiverCT@gmail.com to confirm

We do not wish to turn anyone away who wishes to attend, but is prevented to, only because of financial reasons. EVERYONE who needs to be here, should be here. Money should never be the reason why people aren't able to access support.

SLIDESHOW: We will be having a slideshow running during the event of our loved ones. Please indicate if you plan to send a photo to have your love one included. Photos must be received by May 5. Message to Bettie-Jeanne Rivard-Darby on FB or email to TCFEastOfTheRiverCT@gmail.com

I will send a photo (or several) by email to TCFEastOfTheRiverCT@gmail.com. It will include the name of my loved one (s)

I will send a photo (or several) by Messenger to Bettie-Jeanne Rivard-Darby

I will not be sending a photo and do not wish my loved one to be included in the slideshow, Thank you.

You should have photos of my loved one (s) already. Please let me know if you want more.

I know that you have some photos on file already AND I want to send more. It will include the name(s) of my loved one(s)

LUNCH TIME: Our plan is to serve grilled cheese made on site, as well as tomato soup. We welcome Pot Luck contributions and Snacks and Desserts. Are You Planning To Bring Any Food or Beverages to share at the Luncheon Table? *

Yes -I can contribute to the Pot Luck

Yes - I can contribute to Snacks

Yes - I can contribute to Desserts

I do plan on having some grilled cheese and soup

I can't eat grilled cheese or soup- I will bring my own lunch

Sorry, it isn't possible for me to bring anything. I wish that I could. I just can't right now.

I can bring some individually bottles beverages

I will try to bring what I am listing in the space below...

FOOD CONTRIBUTION: I will try to bring some things to contribute to the day. Here is what I am thinking about. (Please try to make a sign with what it is and list major ingredients) *

VOLUNTEER OPPORTUNITY

I would really Like to help with some of the BEFORE EVENT needs.

I have a friend or family member who doesn't need to go to the Workshops, AND would like to help with cooking lunch

I can help with getting food donations

I think I know someone or a business who might wish to sponsor or donate to the Event

I will email Bettie-Jeanne at TCFEastOfTheRiverCT@gmail.com to talk about volunteering

I will message Bettie-Jeanne Rivard-Darby on Facebook to talk about volunteering

I can help with early morning set up

I can stay later to help clean up

Angels Across The USA Information - https://angelsacrosstheusa.org/

GGo To Alan's Blog to learn more about Alan and the Angels Across the USA Tour 2019

SPONSORING A BUTTERFLY to place on the Angels Across the USA Tour Van

I would like to make arrangements to sponsor a Butterfly ahead of time - the donation is $100.00. Pre-orders can be made directly at the Angels Across The USA site at https://angelsacrosstheusa.org/Sponsor-The-Tour - Payment through PayPal. I will receive my butterfly the day of the event and place it on the Van where I wish my loved one to travel.

I hope to sponsor a Butterfly on the Day of the Event, for $100.00, and will bring payment on that day. On site payment includes cash, check and "Plastic"

I don't understand what this is about "A Butterflyâ€ . I will check for DETAILED INFORMATION ABOUT THE BUTTERFLIES at http://www.tcfeastoftheriver.org/events/alan-pedersen-workshop-5-11-19/sponsorbutterfly2019/ and /or at https://angelsacrosstheusa.org/Sponsor-The-Tour. If I have any questions I will send a note to TCFEastOfTheRiverCT@gmail.com SUBJECT: BUTTERFLY?

Liability Waiver (Type name and date to complete registration) *

In consideration of being accepted as a participant in the Workshop Day With Alan Pedersen, 1. I hereby grant the permission for use of my name and/or picture in any broadcast, photograph, video, or other account of The Compassionate Friends, Inc., Angels Across the USA 2. That I assume all responsibility for any and all damages to, or theft of, my personal property and /or any bodily injury, including and not limited to any physical conditions or aliments relating from food allergies or food consumption that may occur to me. 3. I assume responsibility for property damage and bodily injury that I may cause to others, in each case arising or resulting from, incidental to, or as a consequence of, my participation in the TCF Special Angels Across the USA Event.

By entering your name and the date above you are electronically signing this waiver. If under 18, please have a parent or guardian sign. EACH INDIVIDUAL MUST BE LISTED AS A SIGNATURE SIGN SEPARATELY

UPDATE MAY 10 –Walk-ins will be WelcomedLunch will still be included for walkinsThough Welcome Gifts and the Slideshow Photos will not be available

Funds to Contribute or Not, You Are Welcome!

space limited to the first 30 registrants

UPDATE MAY 10 –
Walk-ins will be Welcomed
Lunch will still be included for walkins
Though Welcome Gifts and the Slideshow Photos will not be available