Registration

First Name (required)

Last Name (required)

Email Address (required)

Please re-enter your email address (required)

Full Address (required)

Primary Phone Number (required)

Cell Phone Number

Emergency Contact Name and Number (required)

Total Attending (required):

List of Registrants (required):

Please provide full names for each registrant and ages for any registrant under 17

Please check if you wish to register:  KlezKanada Poetry Retreat

Accommodations (required):

Prices are per person. For accommodation details, please refer to descriptions at the top of the page.

Retreat Centre (2 per room) $1095Chef's House (2 per room, private bathroom) $1045Chef's house (2 per room, shared bathroom) $990Residence (2 per room) $990Residence (4 per room) $880Family House $935Cabins and Tents $825Off-site $770

Deductions:

13-16 years old deduct per child $75, 12 years and under deduct per child $100, Under 5 years no charge

Travel Plans:

Please let us know how you will be arriving

Shuttle Service TO KlezKanada (required):

Will you need a shuttle from Montreal to Camp B'nai Brith? $20 per person.

None12:30pm from Dorval Train Station1pm from the Federation Building (5151 Cote St Catherine Rd)1pm from Trudeau International Airport3pm from Trudeau International Airport

Shuttle Service FROM KlezKanada (required):

Will you need a shuttle from Camp B'nai Brith to Montreal? $20 per person.

None6am to Trudeau International Airport and Dorval Train Station9am to Trudeau International Airport and Dorval Train Station2pm to Trudeau International Airport and Dorval Train Station2pm to the Federation Building (5151 Cote St Catherine Rd)

Dietary Requirements (check all that apply) (required):

 None Vegetarian Vegan Lactose Intolerant Gluten Intolerant Other

Are there any other medical problems that we should be aware of?

Total Payment (required):

Method of Payment (required):

We will contact you to arrange payment.

 Cheque (please mail) Credit Card (please contact us - see sidebar for contact details)