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REMAINING BALANCE PAYMENT

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Girlfriend’s Weekend Retreat January 25-27 2013

Name:
Address:
Tel: eMail:
facebook Name Twitter:
Single Occupancy $175/pp   Yes   No
Can we room you with someone?   Yes   No
With a Group?   Yes   No   Name of Group
Two per Room? $110/pp   Yes   No
Three per Room? $100/pp   Yes   No
Who would you like to room with?
(upon availability):
Non-Refundable Deposit $25/pp   PAID
(1/2 Non-Refundable Balance Due by Nov. 1, 2012 Remainder Due by Jan. 11, 2013)