Registration Form
2002 Langston Hughes Children's Literature Festival
Friday, August 2 (1:00p.m.) - Sunday, August 4, 2002 (1:00p.m.)
Children's Defense Fund
The former Alex Haley Farm, Clinton, TN

* $210 three-day registration fee covers all sessions, meals, and festival materials.
* One-day registrations are available for $70 per day (includes all sessions, meals, and materials on selected date(s)).
* Only payments in full will be accepted.
* Confirmation of registration will be sent within 15 days of receipt.


Name:________________________________________________________________________________


Name (as it should appear on name badge):_________________________________________________

Address: ______________________________________________________________________________

City/State/Zip: _________________________________________________________________________

Telephone: Day (   ) ______________ Evening (   ) ______________ Fax/Email ___________________

* Please note if you have accessibility or any other special needs.

Check one of the following: (checks/money orders/purchase orders should be made out to the "Children's Defense Fund")

* Enclosed is my check or money order for $210 for full, three-day registration.

* Enclosed is my check or money order for $70 for one-day registration for ______________ (date).

* Enclosed is my purchase order # ____________________ for $210 Registration for full, three-day registration.

* Enclosed is my purchase order # ____________________ for $70 for one-day registration for _________________(date).

* Please charge $210 Registration to my (circle one):
Visa, Mastercard, American Express, Discover Card# __________________ Exp. Date ________

* Please charge $70 Registration for one-day to my (circle one):
Visa, Mastercard, American Express, Discover Card# __________________ Exp. Date ________

Send your registration & fee to: CDF/Former Alex Haley Farm, P.O. Box 840, Clinton, TN 37717

CANCELLATION Policy: Cancellation must be submitted in writing. Only three-day registrations may be refunded. Registration fees will be refunded for cancellations postmarked on or before July 2, less a $50 processing fee. 

We thank all that come to the Haley Farm for helping us to maintain a smoke-free, alcohol-free, violence-free, and hate-free environment grounded in love and mutual respect.