Name *

First Name

Last Name

Phone *

(###)

###

####

Standard Retreat Fee & Hotel (by 4/13) *

STANDARD RETREAT FEE $40 PLUS FAIRBRIDGE INN DOUBLE QUEEN ROOM FEE

SHARED QUEEN BED $43 (plus $40 retreat fee $83 total)

SINGLE QUEEN BED $86 (plus $40 retreat fee = $126 total)

NOT STAYING AT THE HOTEL ($40 retreat fee)

Late Registration after 4/13 ($50 retreat fee)

Carpool *

Intersted in carpooling to this event?

I am staying at the hotel and would like to carpool

I am staying in Post Falls and would like to carpool

I do not want to carpool

I would like to drive and I have room for others