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.