Women’s Retreat 2025 Register Here Name(Required) First Last Email(Required) Cell Phone(Required)Choose an option: Full weekend retreat in a DOUBLE room – $436 (includes all programming, room, food, linens, & swag) Full weekend retreat in a TRIPLE room – $396 (includes all programming, room, food, linens, & swag) Saturday day-pass (8 am – 9 pm, or any part of the day) – $172 (includes 3 meals, programming, & swag) Day Pass Saturday day-pass (8 am – 9 pm, or any part of the day) – (includes 3 meals, programming, & swag) If there is someone you would like to share a room with?(Required) Yes (please list them below) No, I am open to rooming with whoever you put me with Person 1 you would like to room with:Please check with them first.Person 2 you would like to room with:Please check with them first.Are you interested in pre-paying for a 1-hour massage at the cost of $120 (including tip)?(Required) Yes No You will be assigned a time between 11 am – 7 pm on Saturday, March 22. Spaces limited to 30 women. There will only be women massage therapists who come to the retreat site. Special Needs (check if applicable): Wheelchair accessible room on first floor Vegetarian meals What is your tshirt size?(Required) Small Medium Large X-Large This is for swagStaff Code SponsorshipWould you like to provide scholarship for those who can’t afford the full cost of the retreat? Full Sponsor – $540 Chai Sponsor – $360 Angel Sponsor – $180 Full Sponsor Amount: $540.00 Chai Sponsor Amount: $540.00 Angel Sponsor Amount: $540.00 Billing DetailsI spoke with Rabbi Missaghieh, and I agreed to pay the following amount of the total cost of the retreat:(Required) Subtotal $0.00 cc fees I wish to cover credit card fees for the temple by increasing my total by 3% Credit Card Fees $0.00 Total Credit Card(Required) American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20252026202720282029203020312032203320342035203620372038203920402041204220432044 Security Code Cardholder Name Billing Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home
