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Sign me up!

Summer 2008

Mail or fax registration to: National MS Society, 14 W. Valerio Street, Santa Barbara, CA 93101 Fax: 805.563.1489

Name: Address: Phone: Mobility device used (if any): I’d like to register for these program(s):

Date of diagnosis: City: E-mail:

Age: Zip:

Hold That Thought!

___

  • #

    attending in City:

on Date:

Name of guests (if any):

New Directions in the MS Treatment & Management Name of guests (if any):

___

  • #

    attending

MS in African Americans ___ Name of guests (if any):

  • #

    attending

($7.00 parking, pay below or upon arrival)

Stress is What You Make of It Name of guests (if any):

___

  • #

    attending in (check one):

Lompoc

Arroyo Grande

Before Disaster Strikes (teleconference)

Parenting with MS ___ # of $5/person tickets (morning only, pay below) ___ # of $20/person tickets (includes Raging Waters, pay below)

Name of guests (include ages of kids & teens):

Taking Care (teleconference)

Name of caregiver:

(Pay below for Physical Activity series. Check page 7 for cost.)

Fitness Series: Type: Fitness Series: Type:

City: City:

Day: Day:

Total Enclosed $

_ _ _ _ _ _ _

Check enclosed or Charge my: Account # Name on Card

Visa

MasterCard AmEx Exp. Date

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