<p> Mishkan Shalom Weekend in the Woods REGISTRATION FORM Deadline extended until May 22! Please register and pay as soon as possible!</p><p>Full Weekend or Partial Weekend (1 overnight + 3 meals) Adults (ages 18+): $140/person full; $85/person partial Children 5-17: $70/child full; $45/child partial Children under 5: free Maximum price $380 per family of 4 for cabin lodging A limited number of private rooms are available, for an additional cost, on a first- come, first-served basis: Add: $45/person for full weekend for queen bed (one room also has bunk bed) with private bath; $35/person for full weekend for bunk beds with shared bath Add: $22.50/person for partial weekend for room with private bath; $17.50/person for partial weekend for room with shared bath</p><p>Name of contact: ______Email: ______Phone #: ______Total Number of people in group: ______Names of participants: ______</p><p>Please place an “X” next to your choices:</p><p>___ Full ___ Partial: Friday night ___ Partial: Saturday night ___ Cabin ___ Private room with private bath ___ Private room with shared bath Total cost: $ ______</p><p>Please list any allergies or medical conditions for each person on this form: ______</p><p>Do you have Cabin Sharing preferences? ______</p><p>Are you interested in carpooling? If yes, please place an “X” next to your choice: ___ Can provide a ride ___ Need a ride</p><p>Are there any particular activities you are able to help with? (Leading an activity, early arrival?) ______Registration forms must be completed, either on paper or on-line. Complete this form, SAVE IT, and email it to: [email protected] OR download form, and deliver or mail to the office. Then, make your payment online at www.mishkan.org OR make check payable to “Mishkan Shalom” and deliver or mail to the office. (Please write “Weekend in the Woods” on the memo line.) Mail to: Mishkan Shalom, 4101 Freeland Avenue, Philadelphia, PA 19128 ATTN: Retreat Committee Questions? Write us at [email protected]</p><p>THANKS FOR REGISTERING! SEE YOU IN THE POCONOS!</p>