For those interested in applying for financial assistance, please Click Here to complete the Newman Year-Round Program Scholarship Application before completing this registration form. 

Please complete the questions on this page for the primary adult registrant (grandparent).

Personal Information for the primary registrant

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I understand that important details about this retreat will be emailed to me at the email address I provided above.

This question is required.

Preferred pronouns:

For more information about pronouns, click here

* 

Please indicate any dietary restrictions:  All meals will be served Kosher Style (no pork or shellfish)

This question is required.

Home Address

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Congregation Affiliation

If you’re affiliated with a Reform (URJ) congregation, tell us which one!

You can type the name of your city or congregation in the field below. If you are not affiliated with a URJ congregation, select “Unaffiliated / Non-Member” from the below drop-down menu.