Name *

First Name

Last Name

Phone Number

(###)

###

####

Will you want 'Oval Chariot Service' to and from the airport in Raleigh?

K Cox the Steward would pick you up, stop at a grocery store and take you back to the airport (which is an hour away) for an extra fee.

Yes

No

The Respite has reserved one camp site for roundhouse guests. There are three other active camp sites. Would you be open to these sites remaining open during your stay? *

Earning revenue from campers is helpful to meet overhead expenses at the Respite!

Yes

I would prefer that the campgrounds closest to the house be reserved during the dates I/we are staying.

No, I would prefer to pay to occupy the entire land during our stay.