Updating MADWR 2020 to MADWR 2022 - Mid-Atlantic Deaf Women Retreat

Name*

First Last

Address*

Street Address City State ZIP Code

Email*

Text or Videophone Number

Text Number
Videophone Number

Enter Your Text or Videophone Number here:*

Emergency Contact - Name*

First Last

Relation

Text Number*

Special Accommodation

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

Special Diet (include what you cannot eat)

ROOMIE(S) PREFERENCE:

2020 Discounts - (will apply to MADWR 2022)

I signed up for Maranatha "5 Ladies in Room $95" - check that option in "Which Retreat Plan would you like to pick?"
I signed up before/by October 31, 2019 - $10 discount (subtract that from Your Total)
I don't remember if I had any discounts

Which Retreat Plan would you like to pick?*

MARANATHA RETREAT OPTIONS*

Maranatha - 2 Ladies - $205.00
Maranatha - 3 Ladies - $155.00
Maranatha - 4 Ladies - $135.00
Maranatha - 5 Ladies - $115.00

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

MEALS ONLY OPTIONS*

Weekend 5 Meals (Sat. Br. - Sun. Lunch) - $75.00
Weekend 6 Meals (Fri. Dinner. - Sun. Lunch) - $90.00
Saturday 3 Meals (Sat. Br - Sat. Dinner) - $60.00

Friday Dinner? Add $15.00*

Yes, I would like Friday Dinner
No, I do not want Friday Dinner

Would you like a black shirt with embroidered MADWR Logo?*

This is OPTIONAL - You can pick POLO long sleeve or T-SHIRT short sleeve. Let us know by August 1, 2022 and we will work out the payment.

Yes, I would like a POLO long sleeve $25
Yes, I would like a T-SHIRT short sleeve $15
No, I do not want a shirt

Pick your size:

Your Total:

$0.00

If there is a difference in the fee that you paid for MADWR 2020, we will let you know. (We will apply $10 discount, if you signed up before/by Oct. 31, 2019)

CAPTCHA