Retreat Registration

Coming Together for a Common Good Economy

Real democracy. Real money. Real power.

The Inn at Shaker Mill Farm
6:00 pm, Friday, January 28 (dinner) to 1:00 pm, Sunday, January 30, 2011 (lunch)

Participants are welcome to arrive any time on Friday. All participants will be asked to help with meal set up, preparation and clean up.

Your Name(s):
Phone(s):
Email:
Address:
City:
State:
Postal Code:
Dietary Restrictions:
	I need help with transportation
	I could drive someone to the retreat and back
There are rooms with a double bed and rooms with two or more single beds. Please indicate your preference. If you know who you want to share the room with, indicate that as well.
Room preference:
Share with:
If you would like to offer an activity during one of our short breaks, please indicate below.
Activity:
As a way of getting to know each other better, we will have a low-key variety show on Saturday night. Serious to silly talents are all welcome: music, dance, juggling, readings, poetry, comedy, skits... If you think you might be interested (no commitment needed), please indicate below.
Saturday Variety Show:
Notes: