CONTACT US Have a question about pricing and availability? Contact Seaton VanderWoude, Director of Community Engagement and Retreat Sales Phone: 301-468-1719 Email: firstname.lastname@example.org Have questions about an event that’s already booked? Contact Steve Simmons, Director of Customer Service. Phone: 717-794-1402 Email: email@example.com Business Hours: Monday-Friday, 9a-5p. ADMINISTRATIVE OFFICES 11300 Rockville Pike, Suite 407 Rockville, MD 20852 (240) 283-6162 RETREAT FACILITY 12750 Buchanan Trail East Waynesboro, PA 17268 (717) 794-2177 Retreat Interest Form Contact InformationOrganization Name(Required) Organization Contact(Required) N/ADr.Mr.Mrs.Ms.Mx.Rav.Rev. Prefix First Last Organization Contact Phone Number(Required)Organization Contact Email(Required) Secondary Contact Name & Email or Phone Number Retreat Request DetailsDates or Range(Required) Are your dates flexible? Yes No Somewhat Flexible Estimated Number of Attendees (ages 5+)(Required) 20-29 30-39 40-75 76-125 126-199 200-300 300+ Other Type of Group(Required) Adults Only Families Schools/Youth Group Other What percentage or number of your group is:Ages 0-4Ages 5-12Age 13+ (including adults) Add RemovePreferred Main Building Full Campus (Requires Group Size of 200+) Multiple Buildings or Lodging Types (Please Write-in below) Nesiya Lodge ----- Hotel Style, 42 Rooms, 82 Queen Beds, 7 Meeting Spaces, Incl. Grand Ballroom Lodge Upper Bet ----- Ski-Lodge Style, 10 Rooms, 20 Queen Beds, Central Lounge, & Porch Balcony Lodge Aleph ----- Ski-Lodge Style, 14 Rooms, 34 Twin Beds, 3 Meeting Spaces, 2 Lounges, Covered Porch & Playground Lodge Lower Bet ----- Hostel-Style, 4 Rooms with 6 Twin-Sized Bunks, & 1 Lg Room with 26 Twin-Sized Bunks Benjamin Cabin Village ----- 8 Cabins with Lockable Partitions making 16 Total Rooms, 20 Twin-Sized Bunks per Cabin, 160 Total Beds Leadership Center ----- Motel Style, 11 Temperature Controlled Rooms, 70 Twin-Sized Bunks, Huge Central Pavilion, Private Firepit, Volleyball Court, & Adjacent Activity Field Macks Camping Village ----- 10 Raised Platforms for Tents, Electrically Equipped, Secluded Grounds with Private Firepits & Bathhouse Tranquility Yurt Village ----- 4 Yurts, 48 Twin-Sized Bunks, Private Grounds near Lake & Farm Upper Cabin Villages ----- 16 Additional Cabins with 24 Total Rooms, Available Seasonally Please Write-in the Buildings or Lodging Types preferred Any Additional Lodging Notes or Requests Single or Shared occupancy? Single Shared Mixed Unsure How many single rooms are needed? FoodHow many meals per person?(Required) Arrival MealBreakfastLunchDinnerSnackDeparture MealBreakfastLunchDinnerSnackAny special dietary needs? OtherWill your group want to utilize any facilitator-lead activites? Yes No Unsure Facilitator-lead Activity Options Ropes Course & Ziplines Pool & Aquatics Center (Seasonal) Lake Access & Boating (Seasonal) Jewish Educational Activities How did you hear about us?(Required)GoogleCamp AttendeePrior GuestReferralOther (Please specificy)Who referred you? If you selected other, how did you hear about us? Anything else we should know about your group? Any additional contact information?NameThis field is for validation purposes and should be left unchanged.