Women's Fall Retreat 2021
November 12-14; 7pm Friday to Sunday morning | 2021 Women's Retreat
Landmark Resort
Egg Harbor, WI
Name
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Email
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This address will receive a confirmation email
Phone
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Emergency Contact
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Emergency Contact Phone Number
*
Will you require a handicap accessible room?
*
Please select one option.
Yes
No
Please check if you require assistance arranging a ride to the Fall Retreat. A member of the committee will be happy to contact you with help.
Please select all that apply.
Yes, please contact me regarding transportation assistance
Nursing mothers - We know it can be hard to travel with a nursing babe. We are excited you are going to be a part of our time together, and want to accommodate you and your baby's needs. If you need help sorting out a rooming situation you feel comfortable with, please check this box and someone will get in touch with you to assist you. We will do our best to ensure you and your babe are comfortable and can rest!
Please select all that apply.
Yes, I am a nursing mom and would like to be contacted
Please select appropriate room type and payment. (Price includes a light continental breakfast on Saturday/Sunday morning and coffee service for the Saturday morning session)
Single One Night Stay (limited availability, only first 4 requests will receive single rooms) ($115)
Single Two Night Stay (limited availability, only first 4 requests will receive single rooms) ($235)
Double Room One Night Stay ($85)
Double Room Two Night Stay ($165)
Triple Room One Night Stay (may possibly have to share a king/queen-sized bed) ($65)
Triple Room Two Night Stay (may possibly have to share a king/queen-sized bed) ($130)
Quad Room One Night Stay (must be willing to share king/queen bed & provide list of all roommates and roommates must agree to same number of night stay) ($55)
Quad Room Two Night Stay (must be willing to share king/queen bed & provide list of all roommates and roommates must agree to same number of night stay) ($110)
Quint Room One Night Stay (must be willing to sleep on pull-out couch or share king/queen bed & provide names of all roommates & agree to same # of night stay) ($50)
Quint Room Two Night Stay (must be willing to sleep on pull-out couch or share king/queen bed & provide names of all roommates & agree to same # of night stay) ($100)
Saturday Only ($25)
I prefer to pay by check to Jacob's Well Church or Cash (please complete Roommate Request section & indicate room type/length of stay in Comments section below) ($0)
I would like to be contacted regarding a scholarship (please complete Roommate Request section & indicate room type/length of stay in Comments section below) ($0)
Single One Night Stay (limited availability, only first 4 requests will receive single rooms) ($115)
Single Two Night Stay (limited availability, only first 4 requests will receive single rooms) ($235)
Double Room One Night Stay ($85)
Double Room Two Night Stay ($165)
Triple Room One Night Stay (may possibly have to share a king/queen-sized bed) ($65)
Triple Room Two Night Stay (may possibly have to share a king/queen-sized bed) ($130)
Quad Room One Night Stay (must be willing to share king/queen bed & provide list of all roommates and roommates must agree to same number of night stay) ($55)
Quad Room Two Night Stay (must be willing to share king/queen bed & provide list of all roommates and roommates must agree to same number of night stay) ($110)
Quint Room One Night Stay (must be willing to sleep on pull-out couch or share king/queen bed & provide names of all roommates & agree to same # of night stay) ($50)
Quint Room Two Night Stay (must be willing to sleep on pull-out couch or share king/queen bed & provide names of all roommates & agree to same # of night stay) ($100)
Saturday Only ($25)
I prefer to pay by check to Jacob's Well Church or Cash (please complete Roommate Request section & indicate room type/length of stay in Comments section below) ($0)
I would like to be contacted regarding a scholarship (please complete Roommate Request section & indicate room type/length of stay in Comments section below) ($0)
Amount
Roommate Request
I acknowledge that I will receive an email prior to the trip with more details and a packing list.
*
Please select all that apply.
Yes
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Description
November 12-14; 7pm Friday to Sunday morning
2021 Women's Retreat
Landmark Resort
Egg Harbor, WI
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