14 th Annual Student Retreat Saturday, February 4, Noon-end of Sun’s game (approx 9:15pm) (Registration/check-in begins at 11am) US Airways Center 201 East Jefferson Street Phoenix, Arizona Registration Total number of students & adults attending the Student Retreat_______________ There is a limit of students per school plus advisor and chaperon(s). The cost is $30.00 for each person who attends, students and adults, (invoice below). The fee includes the Phoenix Suns vs. the Charlotte Bobcats game immediately following the retreat. (In the event that the game is canceled, for each registration paid in full, you will receive one future game ticket voucher. The AAJHSC will sponsor a dance with a live DJ at the US Airways Center in place of the canceled game.) *Please note that backpacks are not allowed in the US Airways Center Name of School ____________________________________ School Address __________________________________ _ _____________________________________ School Phone ______________________________________ Advisor’s Name(s)______________________________________ ______________________________________ Advisor’s Cell # ______________________________________ Please return this form by fax or by January 27, 2012 or call us at (John) or (Susin) or at or fax to to notify us of the number attending (and shirt sizes) so we can insure there will be enough materials for all persons attending. The Student Retreat Agenda will be available at aajhsc.org prior to the event.  Please see next page for shirt order! 

14 th Annual Student Retreat Shirt Order School name __________________________________ Please complete shirt sizes for each participant (students & adults): Shirts are adult sizes: small, medium, large, x large and xx large Number of: small_________ medium_________ large _________ X large _________ 2X large_________ We must receive this form by January 27, 2012 to insure you get your shirts! Phone Fax There is an invoice below to fill in for your business department or we can send an invoice when we receive your PO.

INVOICE Invoice Date: _____________________ PO Box Tucson AZ Phone: Fax: Taxpayer ID# District Billing Address:School Address: District Name: School: Accounts Payable/Student Activity Advisor Name: District Address: Address: City/State/Zip QtyDescriptionAmount EachAmount Registration fee for 14 th Annual$30.00 Student Retreat on 2/4/12 at US Airways Center in Phoenix AZ PO# Subtotal: Tax:XXXXXX Shipping:XXXXXX Grand Total: