I. GENERAL INFORMATION
*
= skip to use the values from last year
Name:
E-mail:
Street Address: *
City: *
State: *
Zip: *
Congregation/Group: *
Birth Date: *
Home Phone: *
Cell Phone: *
Work Phone: *
Emergency Contact:
Important Medical Information:
Privacy:
Name will be posted on the Winter Escape web page. Name, email, ride information, activity preference and food concerns will be shared with all participants. Den parents may see any of the other information on the form. Emergency Contact information and important medical information
will be available to all participants at the trip if there is an
emergency.
II. HOUSING ARRANGEMENTS
PLEASE READ CAREFULLY: House Preferences:
The house choices are described here .
Second choice:
Third choice:
Additional housing / bed information:
Attending As:
Couples Only:
$15 per person. Singles Only:
I would like to share a room with
$15 discount.
Pets:
$50 fee , and the organizers consider each pet on a case-by-case basis.
III. FOOD ARRANGEMENTS Meals are handled by having everyone prepare one
meal and clean up one meal. More information, including sample menus,
can be found here
Food Preparation: I prefer to prepare
Food Cleanup: I prefer to clean up
Food Concerns: List any allergies you have:
IV. ACTIVITIES To help folks organize, we'll share this information with the group.
Activity Preference:
V. CARPOOL ARRANGEMENTS We encourage carpooling. However, arranging
carpools is a surprising amount of work, so we don't do that. Instead,
we facilitate carpooling by collecting the information in this section
and sending it to all participants, to help people can work out their
own arrangements.
Heading to Event:
Day
Time
Location
Comment Returning from Event:
Day
Time
Location
Comment VI. EARLY BREAKAWAY Some folks can come up a day early, so we open up a
few houses and start the Escape on Thursday. Since there are fewer
people, it's even more informal than the Escape. We even do some of the
organization through emails to each other.$30 Food Preparation: I prefer to prepare
Food Cleanup: I prefer to clean up
Comments: Any comments you might have about the Early Breakaway:
VII. COMMENTS Please post your comments here or tell us anything else that would make the retreat more enjoyable for you:
VIII. COMMUNICATION Information will be provided to you in a few ways
Basic information about the trip, which is especially good for new folks, can be found at http://users.erols.com/pdahl/winterescape/
Announcements and information for all participants will be sent to our
listserv. We HIGHLY recommend you sign up for it through the link
below, since you may miss important information if you don't.
Please join the event listserv .
IX. PAYMENT
The registration fee is a sliding scale, pay what you can afford and you think the weekend is worth.January 31, 2008 or, if it's after the deadline, as soon as you can.Registrar Amount Due
Payment Amount
$ Amount Due After Accommodations are Confirmed
Payment Type
winter-escape-registrar@critmass.org Comments
X. RETREAT AGREEMENT
Please read and indicate your agreement by typing your full name into the Signature box below:
I agree to behave in a manner that is appropriate and cooperative in the effort to create a caring, sharing community. I understand that the retreat organizers reserve the right to
remove anyone from the retreat at any time, for any reason they deem
appropriate.
Signature:
