Registration Form - Havurah Shir Hadash

Registration Form
Havurah Shir Hadash in Ashland, Oregon
“Reb Zalman Legacy Shabbaton with Eve Ilsen, April 24-26, 2015
Send or FAX to: Havurah Shir Hadash, P.O. Box 1262 Ashland, Oregon 97520
Phone: 541-488-7716 FAX: 541-622-0203 www.havurahshirhadash.org
Questions? Contact Ayala at ayala@ashlandhavurah.org
Registrants Names: 1.________________________________________________________
2.________________________________________________________
3. ________________________________________________________
Kids for childcare 1. _________________________________ AGE _______________
Please indicate name 2. _________________________________ AGE _______________
and age of each child 3. _________________________________ AGE _______________
Contact Info: Name __________________Phone (
)_____________ E-mail: ________________________
Address___________________________________________________________________________________
_________________________________________________________________________________________
Payment enclosed:
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Number
Registration @ $225 each….……….………………………………………………... ______
Youth discount (subtract $75 for children and teens up to 18 years of age*)……….. ______
Mitzvah/optional donation to our special needs Scholarship fund………………… ______
Childcare Registration - $20 per child (childcare provided ONLY with advance registration) ______
Men’s Mikvah - $12-$18 per person (see FAQ’s for details)………………………. ______
Women’s Mikvah - $12-$18 per person (see FAQ’s for details)…………………… ______
• Youth 14-18 yrs are eligible for Work Trade Scholarship
$ Total
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______
______
______
______
______
TOTAL DUE…………………………………………………………………………… ______ ______
Payment (your reservation will be held after full payment only):
• Check enclosed [ ]
• Credit Card: [ ] Visa [ ] Master Card [ ] American Express [ ] Discover
Name as it appears on the card: ___________________________________________________
Credit Card Number: ________________________________________ 3-digit Security Code______
Expiration Date: ____________
REGISTRATION
Registration is guaranteed by payment in full only. You may register by sending this form by fax or mail to
FAX to: 541-622-0203 Or Mail to: Havurah Shir Hadash, P.O. Box 1262 Ashland, Oregon 97520
Additional info and forms available online at www.havurahshirhadash.org. We urge you to register early as
space for this event is limited!
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CANCELLATION POLICY
$25 cancelation fee if you cancel before February 15; $50 cancellation fee if you cancel before March 15; $75
cancellation fee if you cancel between March 15 and April 24.
CHILDCARE
Please see FAQ’s – childcare will only be provided if registrations for childcare are received by March 15.
WORK TRADE SCHOLARSHIPS
We don't want finances to be a reason to keep anyone away, so we do have a limited number of work trade
opportunities available. If you are in financial need and are willing and able to work 5 hours over the weekend
please contact Ayala Zonnenschein at ayala@ashlandhavurah.org and write “work trade” in the subject line to
arrange for a $75 work trade discount. You will be notified closer to the time of the Shabbaton in regards to
what exactly your work trade is. We will send you a form where you can indicate your preferences and abilities,
and we will do our best to honor that when possible.
Accommodations – See our FAQ’s for info and rates.
Shabbaton Tentative Schedule, April 24-26, 2015
Friday:
2-3:00 PM
3:30-4:30 PM
3:30-5:30 PM
6:30 PM
7:15 PM
9:30 PM-ish
Woman’s Mikvah at the Jackson Hot Springs on Highway 99
Men’s Mikvah led by Reb David
Pick up your registration packet at the Havurah 185 North Mountain Av in Ashland
Registration and Sanctuary opens
Kabbalat Shabbat (starts promptly...arrive early please)
Oneg
Saturday:
10 AM
1 PM-ish
1:45 PM-ish
Davvenen and Torah service
Lunch catered by Greenleaf Restaurant
Shabbos rest or some wonderful one-hour workshops.
7:30 PM
Evening Program TBA
Sunday:
9:30 AM
10:30 AM
11:30 AM
Shuk open and light breakfast
Davvenen led by rabbis *
Closing ceremony
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