JWC Retreat Reservation Form

JWC 12th Annual Retreat

Yes! I would like to register for the Jewish Women's Circle 12th Annual Retreat.

Your Information

First Name Last Name

Email Address

I would like to pay with cash check.

I would like to pay $350.00 Dollars.

I would like to pay Q2800.00 Quetzales.

Additionally, I would like to sponsor the following amount:

The following are my food restrictions (ex. meat, dairy, fish):

I would like to receive directions, I will be driving on my own .

I would like to get a ride from the Chabad House preferably at o'clock.

I would like to share a room with:

Please be aware that there are limited rooms, therefore your payment is your reservation, on a first come first serve basis.