Thanksgiving 2019 Shabbaton Registration

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* First name:

* Last name:

Attending with a spouse?

Yes No

Spouse's first name:

Spouse's last name:

Number of children over age 14:

Number of children ages 5-14:

Number of children ages 2-4:

Number of children under 2:

* Email address:

Phone number:

Mailing address:

Apartment number:

City:

State:

Zip code:

Would you like to attend:

If single, would you like to request a private room? +$95+tax/night

Yes No

Any additional nights at the hotel? +$155.00+tax/night

Select additional nights:

Wednesday Sunday

Would you like to request a roll-away bed (+$25+tax/night)? **

Yes No

Would you like to request a crib (+$30 for basic program or +$45 for full program)? **

Yes No

Would you like to request a high chair (+$30 for basic program or +$40 for full program )? **

Yes No

Would you like to request connecting rooms (+25+tax/night)? **

Yes No

Questions, comments, or special requests:

* required fields

** Rollaways, cribs, and highchairs are limited and are first-come-first-serve.

*** All prices are double-occupancy (at least two adults per room); children in room with parents. All room rates are subject to 9.5% tax.

Please list the names and ages of your children so that we may direct them to the appropriate children's program:

Name:

Age:

Girl Boy
Girl Boy
Girl Boy
Girl Boy
Girl Boy
Girl Boy

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