A.R.E.
Spring Seabeck Retreat
2010
Registration Form (print
this page,
fill it out and mail with payment)
Name_____________________________________________________Gender M / F
Address _____________________________________________________________
City ________________________________ State _______ Zip _________________
Phone (Day) __________________________ Evening _________________________
Email ________________________________________________________________
Special Diets: Vegetarian __________ Vegan _________ Food Allergies ________________________
Special Accommodations: (I.E. No staris, Near Bathroom, etc.)
If possible, put me with ______________________________________________
Second Person
Name_____________________________________________________Gender M / F
Special Diets: Vegetarian __________ Vegan _________ Food Allergies ________________________
Special Accommodations: (I.E. No staris, Near Bathroom, etc.)
If possible, put me with ______________________________________________
Please note: Your registration cost covers the entire program including lodging, meals and tuition.
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Adults (Pines lodging, meals, tuition) $245 |
x _____ |
= ____________ |
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Senior (65+ Pines lodging, meals tuition) $235 |
x _____ |
= ____________ |
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SURCHARGES (add to basic charges) |
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Spruce (w/bath + $25 Per Person double occupancy |
x _____ |
= ____________ |
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Inn (Upstairs) add $15 double occupancy |
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Inn & Annex Private Room, if available; + $40 (extremely limited) |
|
= ____________ |
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Donation to Spring Seabeck Scholarship fund |
|
= ____________ |
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Discounts: Early Registration (Postmark before February 14, 2010) |
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Per Person: Deduct $20 |
x _____ |
= ____________ |
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SUBTOTAL |
|
= ____________ |
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Deposit: $90 Per Person is non-refundable after February 20th |
|
= ____________ |
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Balance due at Seabeck: |
= ____________ |
Payment (U.S. Funds) Make check payable to A.R.E. Puget Sound Area Team
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