Registration Form for the Young Democratic Socialists and Youth Summer Retreat

2010 YDS Summer Retreat
& Activist Conference
August 5-8, 2010
Valley Brook Inn

201 Kingston Ave, Rt. 209 ● Wurtsboro, NY

Full registration includes all conference activities:
• extensive conference materials
• swimming, sports, and movies
• housing in cabins with individual bathrooms
• breakfasts, lunches, & dinners
• party

Please complete the information below...

Please carefully select the dates of your attendance. The dates cover the days you will be at the retreat. The discounted rates shown are valid for registrations that are made online or postmarked by Monday, July 19th. Full payment or at least a non-refundable $85 deposit must be made or postmarked by July 19th, with the remaining balance to be paid made no later than your arrival at the site. We expect to use all of the available space at Valley Brook Inn so your prompt registration is essential. Please note, no meals will be provided on Thursday. After July 19th a $100 deposit will be required and the higher rates will be in effect.
Student/Unemployed Youth Rates

$220 Thursday 8/5 to Sunday 8/8  ($270 after July 19th)  $Best Deal$
$150 Friday 8/6 to Sunday 8/8  ($185 after July 19th)
$105 Saturday 8/7 to Sunday 8/8  ($145 after July 19th)
$150 Thursday 8/5 to Saturday 8/7  ($185 after July 19th)
$105 Friday 8/6 to Saturday 8/7  ($145 after July 19th)
$95 Thursday 8/5 to Friday 8/6  ($120 after July 19th)


Working Youth Rates

$265 Thursday 8/5 to Sunday 8/8  ($300 after July 19th)   $Best Deal$
$195 Friday 8/6 to Sunday 8/8  ($225 after July 19th)
$135 Saturday 8/7 to Sunday 8/8  ($155 after July 19th)
$195 Thursday 8/5 to Saturday 8/7  ($225 after July 19th)
$135 Friday 8/6 to Saturday 8/7  ($155 after July 19th)
$125 Thursday 8/5 to Friday 8/6  ($145 after July 19th)


[All rates are per person, double occupancy, and include taxes and meals. It is unlikely that single rooms will be available. If you want to share with a specific person both of you should indicate that on the registration form. If you require a single room or have any other special housing need call our office at 212 727 8610.]
Solidarity Contribution

Many young activists are dependent on scholarships to attend this conference. But we can’t provide these scholarships without your help. If you are able, please make a solidarity contribution. All working youth rates will include the option of making a solidarity contribution of $25 per night. In the shopping cart simply choose the number of nights you can contribute and hit the recalculate button. Students who are able to make a contribution should consider paying the working youth rate.
Scholarships

I have special financial circumstances and wish to apply for a scholarship.  Please click on your attendance dates above and see the scholarship application at the bottom of this form. We expect to have only enough scholarship funds to help those attending the full conference. We will not accept scholarship applications after July 18th.
Housing accommodations:
Your housing is covered with your registration.
Car Pooling:
A great way to save money on travel is to carpool. Both sides save when gas costs are shared, and YDS encourages conference attendees to look into carpooling from their communities. YDS will help coordinate carpooling efforts for those who fill out the section below.

I am interested in carpooling with someone.
I need transportation from (list location).

I have car and am willing to take others.
I can provide transportation from (list location).
I have room for passengers.
Enter your information:
First Name
Last Name
Email Address
Address
City/State/Zip
Phone
School (if applicable)
Graduation Date
(if applicable)
Organisation
(campus, community, and/or union)
Age

YDS Member?
(check all that apply)
 Yes No Thinking about joining
Interested in starting a chapter
How did you first find out about the conference? YDS Website
Facebook.com
CampusActivism.org
Listserv
Flyer
Friend
other   
What are the issues that most interest you?:
Please enter additional comments or questions below:
Payment method:
Discounted registration rates are only available if paid on-line or post-marked by July 19th. After July 19 a $100 deposit or full payment of the higher rates will be required. (see above)

Pay $85 non-refundable deposit by mail. The remainder can be paid on site.
Pay $85 non-refundable deposit on-line with credit card (VISA or Mastercard only). The remainder can be paid on site.
Pay in full by mail
Pay in full on-line with credit card (VISA or Mastercard only)

Once you have completed this form, please click the “Send Form” button below.
IF YOU ARE PAYING ON-LINE WITH A CREDIT CARD, YOU MUST CLICK ON THE LINK PROVIDED IN THE PAGE THAT FOLLOWS ONCE YOU HAVE SUBMITTED THIS FORM. You will be sent to a separate on-line payment form.



Retreat Scholarship Application
To apply for a retreat scholarship, please click on your attendance dates in the first part of the registration form. Answer the questions below and email your answers to yds@dsausa.org with the subject line “scholarship.” Each answer should be no more than 200 words. We recommend doing a draft in Word before submitting this online. Applications are due by July 18. We will let applicants know by Tuesday, July 20 how much they have been allotted. Preference goes to YDS members and those wanting to start chapters who are attending the entire conference.

1) Please tell us your estimated travel costs (bus, train, or plane tickets, gas, etc.), how you reached that figure, and how long you intend to be at the retreat. Please note: we only subsidize non refundable 21 day or greater advance purchase plane tickets. For example a person traveling on 8/5 and returning the evening of 8/8 would need to purchase their ticket by July 16, and nowadays the best fares are often sold out by then.

2) Have you done any personal fundraising or applied for money from your school. If so, what? If not, why?

3) Why do you feel you deserve a scholarship?