Include $40 deposit per person, payable to Quaker Center. Mail to:

PROGRAM DIRECTOR
QUAKER CENTER
P.O. BOX 686
BEN LOMOND, CA 95005

Name(s): ______________________________________________________________

Address: ______________________________________________________________

City and Zip: ___________________________________________________________

Phone: (____) ___________

E-mail: _________________________

Diet Restrictions/Special Housing Requirements:

______________________________________________________

_______ I prefer to sleep in the Orchard Lodge.

_______ Put me in the Redwood Lodge if needed.

_______I can offer a ride.

_______I need a ride          _______I need a map

WOMEN'S RETREAT - REGISTRATION