Registration Form | Shavuot NW 2012

First, to ensure you are not a robot, please answer this anti-spam simple math question: 6 + 1 =*

Your Information:

Your First and Last Name*

Your Mailing Address

E-Mail Address*

Contact Phone Number*

What is your preferred way for us to contact you if we have a question?*

If by phone, is there a best time to call?

First & Last Names of All Family Members Attending With You: (separated by a comma)

REGISTRATION OPTIONS

Please select the appropriate registration type (Single or Family), your lodging choices, type of room (sleeps 4 or sleeps 6) and your meal packages. Please note that there are a limited number of rooms and cabins that sleep 6, so these will be reserved on a first come- first served basis after receipt of payment.

Please choose one:* Single ($20) Family ($30)

LODGING

If you need more than one lodging option (such as both a cabin and a Riverfront Lodge room) or more than one of the same type of room (such as 2 rooms, 2 cabins, or 2 RV/tent sites), just select one option now and let us know in the Additional Information box below. More than one option and additional quantities can also be selected at time of payment in the shopping cart.

Check this box if you would like your lodging selection to include extended stay option for Sunday night

Check this box if you would like connecting adjoining rooms in the Riverfront Lodge.

If you need a handicap accessible room in the Riverfront Lodge, please tell us in the Additional Information box below. You may also call Sandi at (503) 570-3376 or email shavuotnw2012@hoshanarabbah.org.

Additional information or special housing needs (including if you wish to share lodging):

MEALS

Meal Package Options: (please choose one)*

Please list any food allergies:

How many Meal Packages do you need?

Number of Adult Meal Packages (Ages 13 years old and up)

Number of Youth Meal Packages (Ages 6-12 years old)

Number of Child Meal Packages (Ages 0-5 years old)

Processing Submission
Close