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CERAASA 2027

Registration Form

CERAASA 2027
Canadian Eastern Regional Alcoholics Anonymous Service Assembly

Area 88 Québec South-West
February 26-28, 2027 St-Hyacinthe, Québec

Registration - EN

First Name

Last Name

Name on Badge

Area

Phone Number

Street Address

Addition Address (unit, APT #, Box)

Town/City

Province/State

Country

Postal Code/Zip

Service Position

GSR or Alt. GSR

DCM or Alt. DCM

District Committee

Central Office/Intergroup

Area Committee

Area Officer

Delegate or Alt. Delegate

Past Delegate

Other Service Position

Please select which ones apply to you....

I would like to participate in a presentation

I would like to animate or help to organise a panel

I would like to be a volunteer at the reception

I would like to be a volunteer to advertising and communications

I would like to be a volunteer at the suite "Hospitality"

I would like to be a transports volunteer

Do you want to help with English/French translation during CERAASA

Yes!

Comments / Addition requirements / Special Needs

Do you Require Vegetarian?

Registrant

Guest

Please Check All That Apply--(1 Registrant per form)

Registration $50.00

Ice Cream $15.00

Saturday Lunch Box $45.45

Buffet $55.00

Buffet for Guest $55.00

Total

Payment

E-transfer funds

By checking this box, you agree to send us an Interac e-Transfer to these details:
E-Transfer to: [email protected]
Password for e-transfer: ASTECAA

Any comments, Questions or Concerns