EmailMe Form - Piedmont Friends 2026 Retreat & Annual Sessions

Name: PERSON 1

First Last

Email

Confirm

MEETING AFFILIATION:

Phone

### - ### - ####

REGISTER SECOND PERSON

Name: PERSON 2

First Last

Email

If different than Person 1.

MEETING AFFILIATION:

Phone

### - ### - ####

REGISTER CHILD/TEEN

Name: CHILD/TEEN 1

First Last

AGE / GENDER

PARENT(S) or GUARDIAN; CELLPHONE #

RESPONSIBLE ADULT (present at Retreat); CELLPHONE #

If different than parent

REGISTER CHILD/TEEN 2

Name: CHILD/TEEN 2

First Last

AGE / GENDER

PARENT(S) or GUARDIAN; CELLPHONE #

RESPONSIBLE ADULT (present at Retreat); CELLPHONE #

If different than parent

REGISTER CHILD/TEEN 3

Name: CHILD/TEEN 3

First Last

AGE / GENDER

PARENT(S) or GUARDIAN; CELLPHONE #

RESPONSIBLE ADULT (present at Retreat); CELLPHONE #

If different than parent

REGISTRANT INFORMATION

Please provide any additional clarifying information about those registering

ACCOMMODATION REQUESTS - MOTEL

Motel Rooms (en suite)
A. 2 Full-sized Beds ($99/room)
B. 1 Queen ADA ($99), limited number, reserved for two registrants

MOTEL ROOM-WAITING LIST
(We'll let you know if a room opens up.)

Friday-A. 2 Full Beds ($99)

Saturday-A. 2 Full Beds ($99)

MOTEL ROOM (Limited number)
Check if you want to be on the WAITING LIST for an ADA Room (1 Queen bed, $99)

Friday- ADA Room

Saturday- ADA Room

MOTEL REQUEST INFORMATION

Names of who will be staying in the room, specify if you are sharing with separate registrant(s).
Let us know if you'd like to share a two-bed motel room with another single registrant, plus any additional information.

ACCOMMODATION REQUESTS - BUNK CABINS

8 Dorm-style bunk beds; linens NOT provided
$43/adult; $12/youth

YOUTH BUNK CABIN

Friday- Teen ($12)

Saurday- Team ($12)

ADULT BUNK CABIN

Friday- Adult ($46)

Saurday- Adult ($46)

BUNK REQUEST INFORMATION

Include name(s) of registrant(s) requesting a bunk.
Let us know any information or questions regarding bunk cabin accommodations.

I am/we are registering as a DAY PARTICIPANT,
NO ACCOMMODATIONS NEEDED.
Saturday Day-Registration Fee of $20 is suggested

YES. I /we will participate FRIDAY

YES. I /we will participate SATURDAY

YES. I/we will participate SUNDAY

I may be interested in participating via Zoom.
Please indicate which of the sessions being explored would be of interest:

Saturday afternoon: PFYM&F Annual Sessions

Sunday morning: Meeting for Worship

MEALS

Breakfast: $12 (Child/Youth $6)
Lunch: $15 (Child/Youth $7)
Dinner: $20 (Child/Youth $10)

All meals are served cafeteria-style in the common dining room. Special diets may be accommodated.
Mealtimes:
Breakfast: 8:00 AM - 8:45 AM
Lunch: 12:00 PM - 12:45 PM
Dinner: 6:00 PM - 6:45 PM

MEALS

	Number Adults	Number Children/Youth
FRIDAY DINNER
SATURDAY BREAKFAST
SATURDAY LUNCH
SATURDAY DINNER
SUNDAY BREAKFAST
SUNDAY LUNCH

DIETARY REQUEST-OTHER

List allergies and other restrictions

DIETARY NEEDS

Vegetarian

Vegan

Gluten-Free

Lactose-Free

PAYMENT

Once reservations have been confirmed, you will receive an email with total charges and payment options.

NOTE: PAYMENT DEADLINE IS MAY 10

The Planning Committee has held concern for the Retreat to be affordable. No registration fee has been assessed. Only Haw River State Park's direct costs for accommodations and meals are being passed on to registrants. Discounts are being offered to families with child/youth. Friends who are able are invited to make a donation to support the Retreat expenses.

Piedmont Friends is financially supporting the programming for children & youth and costs of providing childcare.
Yes, I would like to make a donation to support children & youth programming.

YES, I'll make a donation online

YES, I'll bring a check/cash Saturday

You will be transferred to the Piedmont Friends STRIPE page for online donations when you SUBMIT this form.

Amount of my Donation to support children & youth programming at the Retreat:

$ Dollars

Yes, I'd like to consider volunteering during the retreat. Opportunities include assisting with children & youth programs, childcare, registration. Please indicate your interest below:

Email with further information will follow

Yes, I'd like to join the "Open Band" for the Saturday night Family Contra/Folk Dance

Include your name, instrument and any questions.

I want to register for online participation:

YES--Saturday morning Zoom-only Deep Listening worship

YES--Saturday afternoon Annual Sessions

Questions or Comments

Once you SUBMIT this registration, a confirmation email will be sent to PERSON 1. You may need to check your spam to find the email.
Further, as the Retreat draws nearer, you will receive emails with more information and details.

Also, you will be transferred to the Piedmont Friends STRIPE page where you may make an online donation.
Simply close the Stripe page if you are not making an online donation; your registration will have already been submitted.