2010 Wiawaka Registration Form
Instructions:
Please complete the form below. An incomplete form may delay processing your registration. You may print this page and mail your registration with a check, or complete and register online. If completing on line, enter information and click "Calculate" and then click  "Next >>" buttons at the bottom of this page.

If registering by mail please print, complete & mail your registration form with deposit check to:
Wiawaka Holiday House
PO Box 564
Troy, NY 12180

A 50% deposit is required with your registration to process your reservation; the balance is due at check in.  Fifty dollars of a deposit will not be refunded for cancellations within 2 weeks of an arrival date.  Groups of 8 or more are advised to contact registrar@wiawaka.org to check on availability and group guidelines.

Questions? Contact Wiawaka's registrar at registrar@wiawaka.org or call 1-877-468-8128
 Wiawaka at Lake George  518-668-9690
Full Name
Address
City State
Zip
Phone (day)
Phone (evening)
E-Mail
Building Preference**
Group Affiliation

Type of Stay


By operating on a sliding scale, women pay according to their means to find respite at Wiawaka.
Women paying above our $110 break even rate help subsidize the visits of those who can afford less.
Please use your total household income as your guideline when selecting your rate.
If you are a woman of means, please consider sponsoring a women in need by making a donation.

       Select a Rate Level. Rates include room and board.
2010 Rates Household Income Per Day
Level 1 Below $20,000 $60
Level 2 Between $21,000 and $40,000 $85
Level 3 Between $41,000 and $60,000 $110
Level 4 Between $61,000 and $100,000 $130
Level 5 Above $101,000 $150

The 2010 season is from June 23rd through Sept. 6th.
Please complete only the green items below. The remainder of the fields are automatically calculated and displayed when you click the 'Calculate' button at the bottom of this page.
Arrival Date 2010
Departure Date 2010
Number of Nights   X $ per night
Total $
A deposit of 50% is required to secure your reservation. You may add workshop fees to this amount.  If adding a workshop fee or paying in full, do not press Calculate at the bottom of this form. $
Payment Method
Due on Arrival $
Donation Levels
Press 'Calculate' to determine 50% deposit.


© 2010 Wiawaka Holiday House on Historic Lake George, NY