Winter Peace Retreat at Spruce Lake
Learning from the Least: Reflections on a Peace Journey with Palestinian Christians
February 12-14, 2016 (Friday-Sunday)
Registration Form
Most rooms accommodate up to four people (a double bed and a bunk bed with private bath), and one or two additional family members may be accommodated in the same room on the floor if you wish to bring sleeping bags for them. Single adults who wish to room together should send in their registration forms together; otherwise they will be paired with other singles. (There is an additional $128 charge for a single person who requests a private room.) Adults who are open to sharing a three-person room will also help us to accommodate more participants at an acceptable cost.

Special needs: If you have dietary restrictions or require other special accommodations (e.g., diabetic, or vegetarian, or difficulty climbing stairs, etc.) please include information about your needs.

Name__________________________________________________________________

Address_______________________________________________________________

City, State____________________________________________ZIP____________

Phone______________________________E-mail_____________________________
[check here ___ if you do not want to be included on the Peace & Justice
Committee's email list.]

Children/Youth:         NAME                      AGE           GENDER

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

____Adults @ $195.00 each              ___________

____Adult/private room @ $323.00 each  ___________

____Youth  @  $67.00 each              ___________

____Children @ $38.00 each             ___________ 

                  (Additional donation ___________) 
     
                                  TOTAL___________

                        Amount Enclosed___________

                Amount Due at Check-in ___________

Cost to Participants:

$195.00 Adults
$323.00 Single adult in private room
$ 67.00 Youth (rooming with parents)
$ 38.00 Children (Ages 6-11)
Children under 6 are free!

[It is possible for adults to register for only the Saturday program; cost is $45, including lunch and supper. Check with us for additional details.]

Note: We do not take credit card payments because of the additional costs involved.

___Check here if you are open to sharing a three-person room (adults only).
Make checks payable to:   Eastern District Conference

Mail this registration form to:
	Carolynn Boyd, Registrar
	1162 Lucy Drive
	Schwenksville, Pa 19473 

Registration deadline is   January 22, 2016*
[*Availability of meals & lodging not guaranteed after Jan. 22nd - check with Registrar]

Any questions?  Need more information?  
See http://efpjc.ppjr.org/retreat/efp162.htm, or
Call  Carolynn Boyd, 610-489-9084, E-mail: fcboyd@verizon.net
  or  Robert Walden, 610-861-0653, E-mail: RWaldenPA@entermail.net