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Little People of America
District 2
2014 Fall Regional
Registration Form
November 7th – 9th, 2014
Woodcliff Lake, New Jersey
TO REGISTER, SIMPLY PRINT OUT PAGES 3 AND 4.
FILL OUT THE FORM, AND MAIL IT ALONG WITH YOUR CHECK TO THE
ADDRESS BELOW:
Mid Hudson Chapter LPA
Ann Ehler
47 Woodward Road
Slate Hill, N.J. 10973
The Mid Hudson Chapter 40 of Little People of America is pleased to be hosting District 2’s upcoming Fall
regional conference. This Fall, we will be at the Hilton at Woodcliff Lake Hotel , over the weekend of
November 7th through the 9th, 2014.
The Hilton at Woodcliff Lake Hotel is located just off the Garden State Parkway, about 30 miles from New
York City, in upstate New Jersey.
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Features of the Hilton at Woodcliff Lake
Full Service Hotel: 200 Tice Restaurant
(Open for Breakfast, Lunch & Dinner.
Nickleby’s Lounge. Onsite Starbucks!
Indoor heated pool & whirlpool spa.
Full Fitness Facility on site.
Guest Rooms Include
2 Full Size Beds or 1 King Size Bed available
37” HDTV in all rooms
Marble bathrooms with hairdryers.
WiFi Internet in rooms.
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Nightly Activities Planned
Friday Nite: Welcome Fire Pit S’Mores Party.
Glow up the Night Dance Party to follow.
Saturday Nite: Fall into Fun Banquet and
Dance.
Nightly room rates are only $119 / night. Reservations can be made by calling the hotel directly at (201) 3913600 or online: http://www.hilton.com/en/hi/groups/personalized/W/WODHIHF-RPA-20141107/index.jhtml
You must mention that you are with Little People of America to get the group rate. Reservations must be made
by October 15th to secure the group rate.
NOTE: You can place your reservations at the hotel prior to registering, but registration is required by every
attendee. Name badges will be issued at registration, and must be worn to attend any event or function. In other
words: no badge, no access, no exceptions!
LPADistrict2∙2014FallRegional∙www.lpadistrict2.org
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Hotel Information
Hilton Woodcliff Lake Hotel
200 Tice Boulevard
Woodcliff Lake, New Jersey
Phone: 201-391-3600
Website: http://www3.hilton.com/en/hotels/new-jersey/hilton-woodcliff-lake-WODHIHF/index.html
LPA Room Rate: $ 119.00 / night (not including local taxes)
Please refer to the hotel’s website for room, service, and amenity information
Please reserve your room today! Cutoff date is: October 15th, 2014
Directions to the Hilton at Woodcliff Lake
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Traveling North: Follow Garden State Parkway North (toll road) to Exit 171. Left at traffic light off
ramp onto Glen Rd. At traffic light turn right onto Chestnut Ridge Rd. At second traffic light make left
onto Tice Blvd. Our NJ hotel near New York City is 1/2 mile down on the left.
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Traveling South: From I87/I287 (New York State Thruway), follow Garden State Parkway Extension
South to SCHOOLHOUSE RD EXIT in NY (no exit number - last exit in New York). Turn left onto
Schoolhouse Rd. Turn right at traffic light onto Summit Ave. Follow to Chestnut Ridge Rd and make a
left. At the 4th traffic light make a right onto Tice Blvd. Our Bergen County hotel is 1/2 mile down on
the left..
LPADistrict2∙2014FallRegional∙www.lpadistrict2.org
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District 2 Fall Regional Registration Form
November 7th -9th, 2014 in Woodcliff Lake, NJ
Family Last Name:
.
Home #
Cell #: ________________________________________.
Work #:
First Name
First Name
LP
Address: ______________________________________
City:
State: _____________________ Zip: ________________
EMAIL:
__
.
_
.
LP
_
.
__
.
Child’s Name ______________LP
Child’s Age: _____ Allergies (if attending Kids’ Room):__________________________________.
Child’s Name ______________LP
Child’s Age: _____ Allergies (if attending Kids’ Room):__________________________________.
Child’s Name ______________LP
Child’s Age: _____ Allergies (if attending Kids’ Room):__________________________________.
Chapter Name and District #: ___________________ Is this your First Regional? ______________________.
REGISTRATION OPENS AT 3PM ON FRIDAY November 7, 2014
*SPECIAL RAFFLE Bring a non-perishable food to donate as an entry for a chance to win a special prize!* Registration
Fees: (All fees must be returned with pages: #1 and 2 only.)
Anyone not active with LPA should contact them via [email protected] or call 1-888-572-2001 to become/reactivate
membership. The National Little People of America web site is: www.lpaonline.org
Registration BEFORE 10/6/ 2014
Dollar Amount
Please Check appropriate box(s).
Single $25.00
Family $35.00
All registration packets received by Oct 6th will be entered into a special raffle.
$
$
.
.
$30.00
$40.00
$
$
.
.
$35.00
$45.00
$
$
.
.
Registration BEFORE 10/15/2014
SingleFamilyRegistration Late or On Site
SingleFamily-
There will be a charge of $10.00 per adult / $5.00 per child 17 and under that is a relative or guest of a member. All guests
must be registered and wear a badge to enter any conference events. List the names of guests below.
Last Name
Last Name
Last Name
First Name
First Name
First Name
.
.
.
Total # _____ Total $_________________.
Registration Required for Kids Room All children must be registered for the Kids Room if they want to be included for the
MAD SCIENTIST performance.
Kids Room- ages 3 & up
Tween Scavenger Hunt
Teen Pizza & Pool Party
$10.00
$ 5.00
$ 5.00
# of boys ___# of girls ___
# of boys ___# of girls ____
# of boys ___# of girls ____
Total Page 1:
$
.
$_________________.
$_________________.
$
.
Please list names, group, sex, and any allergies or special needs on back of this page.
Date received:
. Check #
. Amount received
LPADistrict2∙2014FallRegional∙www.lpadistrict2.org
. Amount owed / due
.
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FRIDAY: Welcome FIRE PIT S’MORES PARTY 7pm to 9pm S’mores & Hot Cocoa
Cash Bar nearby
Adult #
Child #
.
. (12 & under)
@ $12.00 per person
@ $ 8.00 per child
$
$
____ .
____ .
$____ _______.
FRIDAY 9pm to 12:30am “GLOW Up The NIGHT” Dance Party with DJ and Cash Bar
SATURDAY: “FALL into FUN” BANQUET & DANCE 6:30pm to 9pm
Join us for a fun evening with friends! There will be a FACE PAINTER, BALLOON ARTIST, PHOTO BOOTH, DANCERS
and a few surprises too! THERE IS A $10.00 Charge for those attending the dance from 9pm -12:30am
Adult Dinner #
.
@$42.00 per person
Total Amount$ ___________.
Filet of Salmon
Total Salmon Dinners _______
Chicken Francaise
Total Chicken Dinners _______
Chateaubriand
Total Beef Dinners
_______
Special meal requests:_____________________________________________
Total Amount$ __________.
Child’s Dinner (12 and under) # _______________. @$18.00 per person
Chicken Fingers & Fries
People only attending dance there is a charge of $10.00 #___
Total Amount $____________.
Total Amount $_____________.
Add Page 1&2 for check Total: $
.
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Group Photo available for purchase! $10.00 each ……… # of photos_______
NO CASH PLEASE! (KEEP A COPY FOR YOUR RECORDS)
Make CHECK OR MONEY ORDER payable to: “LPA CHAPTER 40”.
Please mail your registration form and check to:
Ann Ehler
Michelle Burke
47 Woodward Road
24 Graney Court
Slate Hill, NY 10973
Pearl River, NY 10965
Volunteers are needed: If you are interested in Volunteering please let us know by filling out the information
below.
Volunteer Name:___________________ When are you available to Volunteer?:_____________
Volunteer Name:___________________ When are you available to Volunteer?:_____________
MAKING YOUR HOTEL RESERVATIONS
Hilton at Woodcliff Lake
200 Tice Blvd
Woodcliff Lake, NJ 07677
Phone: 1-201-391-3600
Fax: 1-201-391-4286
Toll Free: 1-800-hiltons
Mention you are with the LPA Regional
Lifeguard Supervised INDOOR POOL / Onsite Bar, Restaurant and Starbucks!
Room Rates are $119.00 plus taxes per night before October 15th
HOTEL WILL PROVIDE A SHUTTLE FROM MONTVALE, NJ TRAIN STATION Check NJ Transit website
Mention you are with the LPA Regional
On site Bar and Restaurant and Starbucks
For assistance completing these forms or for any additional questions, please contact:
Ann Ehler @ 845-591-5150 or [email protected] OR Michelle Burke @ 845-536-7144 or [email protected]
LPADistrict2∙2014FallRegional∙www.lpadistrict2.org
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Events
Group Photo will be prior to banquet at 6pm on Saturday!
Special Raffle: Bring a non-perishable food item to donate and be entered in a special raffle. All food
will be donated to a local food pantry. Share your good fortune with others!
Please note: To insure the safety and security of all those attending this regional conference, name badges must
be worn at all times. NO ONE will gain entrance to any activities without the proper regional ID.
WORKSHOP INFORMATION WILL BE AVAILABLE AT THE REGISTRATION DESK
Doctors from Hospital for Special Surgery and Colleen Gioffreda from Johns Hopkin will be presenting
at workshops. Please include areas of concern you would like addressed.
“Kids” Room: Ages 3 and up
Children will enjoy activities monitored by volunteers. Activities include games, toys, and crafts. Parents
planning to attend a workshop can utilize our “kids” room from 8:30am to 12:00pm. We will be having an
afternoon session from 1:30pm to 4:00pm and there will be a performance by “THE MAD SCIENTIST” from
2-3pm. Please do not leave the Hotel while your child or children are in the Kids Room. There will be
refreshments provided. Be sure to let us know if there are any special needs or allergies.
TWEEN SCAVENGER HUNT: Ages 10 and up
We will be holding an indoor scavenger hunt. The tweens will go on an adventure and uncover hidden items.
Of course, they will need supplies! We will be giving prizes in different categories and snack packs to keep
them happy while they’re on the hunt!
TEEN POOL and PIZZA PARTY: Ages 13 and up
Pizza and laughs with friends. Pool is fully accessible! Raffle prizes will be given out!
General Assembly Meeting: Please join us for a General Assembly. Here about what is happening with
District 2 and discuss future events. Saturday, November 7th @ 9:15am-10:00am.
NO Smoking: NJ State law states that smoking shall not be permitted inside. There are posted smoking
areas outside the hotel.
Alcohol Use Under the Age of 21: Individuals under the age of 21 who are determined by hotel
security, police, or an LPA official to be under the influence of alcohol at an LPA Event may not be allowed to
attend another LPA Event until the age 21 and they may be removed from the current Event site.
AREA ATTRACTIONS
Enjoy the park-like setting surrounding Hilton Woodcliff Lake with pools, racquetball courts, and a fitness trail. Venture
off beautifully landscaped acreage and discover Bergen County attractions and things to do in New York City. Engage
the family at the New Jersey Children’s Museum or the New Jersey Performing Arts Center. Outdoor enthusiasts
should consider Harriman State Park, less than 20 miles from this Woodcliff Lake, New Jersey hotel. Sports enthusiasts
can enjoy a New York Giants or New York Jets football game at MetLife Stadium in East Rutherford's Meadowlands –
home of the 2014 Super Bowl. Visit West Point for an Army football game. Tice’s Corner Marketplace – only steps
from the hotel – caters to the discerning shopper with over 20 distinctive stores. Woodbury Common Premium Outlets
offer designer brands and impressive savings. Drive about 35 miles to Liberty State Park and take the ferry to the Statue
of Liberty and Ellis Island. New York City offers fabulous museums and cultural and dining venues. Appreciate artifacts
at West Point Museum while visiting the United States Military Academy at West Point.
Palisades Mall: Has it all! Movies, Dave & Busters, shopping. 1000 Palisades Center Drive, West Nyack, NY 10994
Shops at Nanuet: Restaurants and shopping! 5101 Fashion Drive, Nanuet, NY 10954
Garden State Plaza: Shopping, shopping, shopping! TAX FREE!!! Exits 160 & 163 off Garden State Parkway
Woodbury Commons Outlets: Name brand outlets! 498 Red Apple Court, Central Valley, NY 10917
Monster Mini Golf: Indoor child-friendly mini golf! 33 Rt 304, Nanuet, NY 10954
LPADistrict2∙2014FallRegional∙www.lpadistrict2.org
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