Enter a title for the group for which you are registering. Group Name:

• Enter the date of your arrival:   Enter the date of your departure:

  Have you called Olmsted to verify that these dates are available?  Yes    No

  Is your group a part of the Western Pennsylvania Conference, United Methodist Church? Yes    No

  Total Number of People:  

  Provide the following information for your contact person:

  First Name
  Last Name
  Street Address
  Address (cont.)
  City
  State/Province
  Zip/Postal Code
  Work Phone
  Home Phone
  E-mail

ROOMING REQUIREMENTS:

• Number of people staying overnight at Olmsted:

• Are there Accessibility Needs for anyone in your group: Yes    No

• If yes, please briefly describe:  

• You will also need to fill out a rooming sheet for your group for Groves Lodge and/or the Manorhouse

MENU PLANNING:

• Number of people eating meals at Olmsted:

• Do you have any special Dietary Needs in your group?  Yes    No

• If yes, please briefly describe:

• First meal requested: Breakfast Lunch Dinner Evening snack        Last meal requested: Breakfast Lunch Dinner Evening Snack

  Sue and her staff are happy to make up the menus for each day of your visit. If you would like to have a menu choice list sent to you please check this box:

  Any Comments?

  PLEASE NOTE: Your registration will be complete upon receipt of $15 per person deposit.  Please send your check for $15 multiplied by the number of people in your group to:  Olmsted Manor Retreat Center, PO Box 8, Ludlow, PA 16333.

(Form will be sent to Olmsted ia email.)