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Eat Pray Learn Application Form

Eat Pray Learn Application Form

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Published by Temple Sinai

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Published by: Temple Sinai on Feb 13, 2012
Copyright:Attribution Non-commercial


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Temple Sinai 2012 Member Retreat

Friday April 27th and Saturday April 28th
Name: ______________________________________________________________________
Address: ____________________________________________________________________
Phone Number: _______________________________________________________________
E-mail Address: ______________________________________________________________
We will be staying at the hotel on Friday night, only. Check-in after 3 pm on Friday; check-out noon Saturday.
Rooms Friday 4/27
(All rooms have a microwave and small refrigerator)
Quantity (of
Luna Studio
(1 King bed, sleeps 2)

Viera Studio
(1 King + 1 Queen Pull-out sofa bed, sleeps 4)


Each adult $90.00

Each child under 10 $60.00

Grand Total:

Full payment is due by March 1, 2012. Advance registration is required as space is limited
Contact: Debra Lazer at the temple for additional information, 254-5110; debra@templesinailv.org.
Make check payable to Temple Sinai and send form to:
9001 Hillpointe Rd. Las Vegas, NV 89134; fax 254-0997.
Credit card payment: Visa / Mastercard / Discover Card (circle one)
Card # ___________________________ Exp. Date _____ Name on Card ______________________
Amount __________________ Deposit ________________________ Date __________________

Please Note: The hotel has a café/coffee shop where breakfast is available. Also, arrangements for a box lunch
can be made.
You may add one more night at the same rate if you wish. Just put the total number of nights on the above form.

* Includes two dinners, gratuities, and all facility services charges. Breakfast and lunch are on your own.

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