Registration Form

Name: ____________________________________________________________________________________

Address: __________________________________________________________________________________

Email address: ___________________________________________________________________________

Phone number(s): _______________________________________________________________________

$295 prior to Sept 7, $325 thereafter, includes a non-refundable fee of $75.

Please make checks payable to Laura Derr and mail to:

30 Neponset Ave., Roslindale, MA 02131.

We appreciate earlier registration to facilitate planning.

Send any questions to Laura at This email address is being protected from spambots. You need JavaScript enabled to view it.

Most rooms are singles with a bath that MAY be shared. Some double rooms are available.

Food allergies: ___________________________________________________________________

Vegetarian: _______________________________________________________________________

If you require a certain food item, please bring it with you. There is a refrigerator for our use.