An Inspiring Weekend Retreat in New York City

 Registration Form

 There will be programs for children during all lectures.

First Name
 

 Last Name

Address 
 

City 

Province 
Postal Code 
Home Phone
Cell Phone
Email Address

 Attendee Information

How many people will be coming?

Adults  
Children
(0-14 years)		  


Please write the full name(s) of all attendees:
Adults:

 

Children:

 

 

Retreat Costs

Round Trip by Luxury Coach Bus
(Payment due with this registration)

Early Bird Registration is open until Wednesday, April 1, 2015 

Number of People:    Early Bird  Regular
 Adult(s)  $180 CND  $225 CND
 Child(ren)
(0-14 years)		  $100 CND  $145 CND

Shabbaton Fees
(Payment due upon arrival in New York)

Shabbaton fees include meals on Shabbat and Sunday morning brunch. 

Number of People:    Cost
 Adult(s)  $130 USD
 Child(ren)
(0-14 years)		  $65 USD



 

Lodgings
Bed & Breakfast Hotel available or billeting with a local family.

Please note: the price will vary depending on lodgings chosen and amount of people sharing the lodgings.

 No, I am not interested in receiving lodgings. I will make my own arrangements.

 Yes, I am interested in receiving lodgings and would like to request:

Bed & Breakfast Hotel
Billeting with a local family


Payment Information

Important: All forms must be completed and submitted with payment for round trip luxury bus.

Total Payment: 
(Bus Fee O)
 		  
 Visa      MC     Amex  
Credit Card Number:  
Credit Card Expiry Date:  
Name on Credit Card:  


Date of Registration:

Additional Notes: