Midtown Women's Retreat 2017 Registration
Lake Gaston | Friday, October 20 - Sunday, October 22
Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
How did you hear about the Women's Retreat?
Midtown Website
Midtown Bulletin
Midtown Update
Friend
Other
Roommate Preference(s):
First & Last Name(s)
I am willing to sleep in the following bed accommodations (we will do our best to accommodate bed preferences):
*
King bed with someone else
Twin bunk alone
Queen bed with someone else
Happy to sleep anywhere!
The house does not provide linens. If you are willing to help bring sheet sets for the beds, please select which type below:
King Set
Twin Set
Queen Set
How many sets of king sheets will you bring?
1
2
3
How many sets of queen sheets will you bring?
1
2
3
How many sets of twin sheets will you bring?
1
2
3
Would you be interested in carpooling with other attendees?
Yes
No
Are you willing to drive your car?
Yes
No
Do you have any dietary restrictions?
Vegetarian
Vegan
Gluten Free
Other
Would you be interested in purchasing a 2017 Women's Retreat t-shirt similar to the above for $15 (could be less if we have a lot of interest!)?
Yes
No
T-Shirt Size (Men's Sizing):
XS
M
S
L
XL
Other
Payment
*
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( X )
USD
$103 Regular $78 Student
Credit Card
Submit
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