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To register more than 1 person, please use our Group Registration Form

Please fill out the information below accurately.

* - Designates a required field

Participant Information

Please fill out the participant information below. This form is for US and Canadian Residents only. Please contact the Teva Learning Center for foreign registration.

If you have any questions, please contact seminar@tevacenter.org or (917) 805-8841

* First Name
* Last Name
* Age
* Gender
Organization
* Address
Address (cont)
* City
* State (abbreviation)
* Zipcode
* Email Address
Phone Number (digits only please)
*How did you hear about the seminar?
Please be specific
*In Case of Emergency Please Contact:
* Emergency Contact:
* Relationship:
* Contact Phone#1
Contact Phone#2
Do you have any allergies to food or medication?
Please be specific
Do you have any special dietary needs? (All meals will be vegetarian)
Do you have any other medical concerns that may limit your ability to participate during the seminar?
Please be in touch with me about train information from NYC to the Seminar
I would like information about carpooling with others from my area.
It is possible I will need to arrive Sunday evening and/or leave Friday morning. Please be in touch with me about those options and costs.

Billing Information

Please fill out the billing information below. This is the address that you would like the receipt returned to.

Check here if participant information is the same as the billing information

* First Name
* Last Name
Organization
* Address
Address (cont)
* City
* State (abbreviation)
* Zipcode

Track Selection

*Please choose the track that is your primary interest. This does not constitute a final commitment to this track, but will allow us to tailor the program to your interests. Portions of the Gardening track will be available only to those who pre-register for that track.

Congregational Education Track
Camp and Wilderness Track
Organic Agriculture and Educational Gardening Track
Ethics and Texts Track

Payment

* Room Type Bunk - $420.00
Double Occupancy Cabin (per person) - $470.00
Private Room - $520.00
Ramada Inn, Fishkill NY - $640.00
* Payment Amount Deposit of $100.00 (Non-refundable)
Pay in Full
Pay By Check (note: registration will not be confirmed until we receive payment)
Alum Discount.
Bring a friend $50 discount will be credited to your account when another person refers to you on their registration form in the 'How did you hear about the Seminar' question.
Id like to help other people attend the Teva Seminar
* Name on the Credit Card
* Type of Credit Card Visa
Mastercard
* Credit Card Number (do not include dashes)
* Expiration Date (mm/yyyy) /
* Zip Code on Credit Card Bill
CLICK TO SUBMIT REGISTRATION
Upon review of your registration information, you will recieve a confirmation, including driving directions and a packing list.
 Seminar Information:
 
Teva Seminar on Jewish Environmental Education
June 2 - 5, 2008
Surprise Lake Camp