MADWR 2021 - One-Time Payment - Mid-Atlantic Deaf Women Retreat

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Text or Videophone Number

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Enter Your Text or Videophone Number here:*

Emergency Contact - Name*

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Relation

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Retreat Theme Shirts (long sleeves) - Pick your size:

Do you want your name on the shirt?

YES, add my name on the shirt - type name below
NO, I don't want my name on the shirt

Type your name as you want it printed on the shirt:

Special Accommodation

Need Accessibility
Need Deaf-Blind Interpreter
Special Diet (describe below)

Special Diet (include what you cannot eat)

ROOMIE(S) PREFERENCE:

Which Retreat Lodging Would You Like To Stay?*

MARANATHA RETREAT OPTIONS*

Maranatha - 2 Ladies - $205.00
Maranatha - 3 Ladies - $155.00
Maranatha - 4 Ladies - $135.00
Maranatha - 5 Ladies - $95.00

WPW RETREAT OPTIONS*

WPW Lodge - 2 Ladies - $215.00
WPW Lodge - 3 Ladies - $165.00
WPW Lodge - 4 Ladies - $145.00
WPW Lodge - 5 Ladies - $125.00

Friday Dinner? Add $15.00

Yes, I would like Friday Dinner

Your Total:

$0.00

Sign up by September 4, 2021, (for FULL refund - let us know by September 4, 2021). --- If you do not receive an email confirmation, please email madwrinfo@gmail to follow up on your registration and payment.

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MADWR 2021 – One-Time Payment

Online Registration 2021 - One-Time Payment