Type of Area (select 0ne): ____General     ____ Chemical Free   ____ Drum Tolerant
Housing :       ____Tent        ____RV(no hook-ups available)       ____Mini Van
                        ____Cabin Space      ____Womym & Babies/Toddlers Cabin
                        ____Moms & Gyrls Cabin     ____Group Cabin
GroupName________________________ There are______(upto 12) of us who wish to be housed together.
Pre-Registration for LakotaInipi Ceremony: * lodges are for first timers only.
        Indicate 1st, 2nd & 3rd choices. Space is limited to 20 each lodge.
        Pre-Registration is a must!
            Thursday =     ______3:00-5:00pm         ______6:00-8:00pm
           Friday       =     ______7:30-9:30am         ______1:00-3:00pm*        ______7:00-9:00pm
            Saturday  =     ______7:30-9:30am*       ______1:00-3:00pm*        ______6:00-8:00pm
Meals: (Pricesinclude three hot vegetarian/non-dairy vegetarian meals a day.)
              Beverages are available for sale)
                           _____ I do not eat dairy(vegan)
                            _____ I eat dairy products (eggs, cheese, cows milk)
                           _____ I will be arriving on Thursday (dinner is the first meal available in camp)
                            _____ I will be arriving on Friday in time for: ____Lunch    ____ Dinner
Special Needs:   _____ ASL interpreter      _____ Differently-abled:_______________________
Gyrlspace registration:        _____Toddler-6years old           _____7-12 years old
             Name(s)_____________________________________________________________
Transportation:   ____ Car
                                ____ I will take____ riders. They can all (       ) _________________to make arrangements.                                                  _____  I am riding with someone else or my car is already full.
                                ____  Bus  Please contact me about shuttle times for Thursday and Sunday.
                                ____ Air I agree to arrive before 2 p.m. Thursday and depart after noon on Sunday.
                                 ____  Please contact me about shuttle rides.
______Please send me a work application: I have enclosed a separate SASE marked "Work Exchange"

Pre -Registration Fees: Atthe gate the fee is $275.00
    Per Womon ....................................$ 265.00             Payment Method:
        ( after May 15th )                                                                               ______Money Order        _____Check
                                                                                                                    ______Visa                       _____MC
   Earlybird Cash Discount (until May 7th) ........ - $10          Card Number: __________________________________________
   check  or money order only)                                                               Exp. Date (mm/yy) __________________
    Gyrls 3-6.......................................add  $ 32.00          Signature: (exactly as it appears on card)
    Gyrls 7-12......................................add $ 64.00          _______________________________
    Roundtripairport per womon.......add $ 30.00
    Roundtripbus stop per womon ...add $ 15.00                       Thank you!
    Total Fees.......................................$_________
    Mail To:         Womongathering       PO Box 559     Franklinville,NJ 08322