WV Women’s Retreat Registration

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* 1. Registration costs for event:

Before 7/1 $25

7/2-8/1 $30

8/2-9/6 $35

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* 2. Contact Information

Name

Home Church

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 3. Will you need van shuttle assistance while at retreat?

Yes

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* 4. I will be attending:

Friday only

Saturday only

Sunday only

Friday and Saturday only

The entire event for all three days

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* 5. Any food allergies?

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* 6. I am reserving a:

Private Room

Double Room with a roommate

Double Room with 2 roommates

Dorm style room with several roommates

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* 7. Please list roommates if applicable:

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* 8. Do you need a handicap room?

Yes

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* 9. I would like to Dorm in:
(Currently Holt Hotel is sold out. If you choose Holt, you will be placed on a waiting list for Holt but will be placed in Main unless a room opens up in Holt.)

Main Private Hotel Style ($75/night)

Main Dorm with several roommates ($20/night)

Main Hotel style with 1 roommate ($36/night)

Mountaineer Private Hotel Style ($82/night)

Mountaineer Dorm Style with several roommates ($20/night)

Mountaineer Hotel Style with 1 roommate ($41/night)

Holt Private Room ($90/night)

Holt Hotel with 1 Roommate ($45/night)

Holt Hotel- I am 3rd person in room ($10/night)

Holt Hotel- I am 4th person in room. ($10/night)

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* 10. I will be eating the following meals:

Friday dinner $9.50

Saturday breakfast at dining hall $6.50

Saturday continental breakfast $5.00

Saturday Lunch $8.00

Saturday dinner $9.50

Sunday Breakfast at dining hall $6.50

Sunday continental breakfast $5.00

Sunday lunch $8.00

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* 11. I will be attending the following interest group:

Best Practices For Rebuilding a Women’s Group-Led by Jennifer Allen

You are not alone-support for family and friends affected by the drug epidemic-Led by Professional/trained counselor

Jewelry Making $10 fee

Hand bells-Led by Lois Coffey

Focusing on your own Spiritual Health-Led by Steven Smith

Painting-Led by Rosetta Smith $10 fee

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* 12. I plan to sing in the choir?

Yes

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* 13. I plan to pay

At the event

Please invoice me to pay by credit card when you receive my registration

I will send a check to the Regional office at 1402 Washington Ave Parkersburg WV 26101

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* 1. Registration costs for event:

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* 2. Contact Information

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* 3. Will you need van shuttle assistance while at retreat?

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* 4. I will be attending:

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* 5. Any food allergies?

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* 6. I am reserving a:

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* 7. Please list roommates if applicable:

Question Title

* 8. Do you need a handicap room?

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* 9. I would like to Dorm in:(Currently Holt Hotel is sold out. If you choose Holt, you will be placed on a waiting list for Holt but will be placed in Main unless a room opens up in Holt.)

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* 10. I will be eating the following meals:

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* 11. I will be attending the following interest group:

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* 12. I plan to sing in the choir?

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* 13. I plan to pay

* 9. I would like to Dorm in:
(Currently Holt Hotel is sold out. If you choose Holt, you will be placed on a waiting list for Holt but will be placed in Main unless a room opens up in Holt.)