Registration Form

First name

Last name

Email

Preferred name/nickname

Gender

Male

Female

Phone Number

Street Address

City

State

Country

Postal Code

Birthday

Age

Emergency Contact

Emergency contact phone number

Emergency contact relationship

Religious Affiliation

What's your Instagram URL

What's your Facebook URL

What's your Linkined URL

Accommodation Preferences

If you have accommodation preferences, please provide the name

Mobility or accessibility needs (ANY difficulty walking/hiking/slopes)

Is there anything else we should know about?

How would you rate your Jewish knowledge?

Very limited

Basic

Moderate

Strong

Are you comfortable participating in Shabbat services, discussions or learning sessions?

Yes

No

Unsure

Why do you want to attend this retreat?

I agree to abide by the retreat’s code of conduct and respect all participants

Yes

I understand that this application does not guarantee a spot—it is a selection process

Yes

Have you already already attended an MJE retreat before?

Yes

No

If you have you already already attended an MJE retreat before, which one?

Ski Retreat

Spring Retreat

Israel Volunteer Trip

None

Are you a MJE Fellow?

Yes

No

If you have already attended a retreat like this before, please tell us what you felt worked and what you’d like differently.

By attending this trip, you are agreeing to have photos/videos taken during the retreat that may be used for our community/future promotions

Yes

I consent to my data being used for retreat logistics and communications

Yes

I certify that the information I have provided is accurate

Yes

Add your details

Vermont Winter Retreat