JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Emerge-Retreat Registration Form
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
First + Last Name please
*
Your answer
Lodging - All beds are QUEEN size
*
Choose
I am flying solo! 1 bed, room entirely to yourself -- $950
SOLD OUT--Buddy Up! 2 beds, 2 people, a bed to myself -- $850
Bunking up! 1 bed, 2 people, a cuddling buddy (or not :) -- $750
Bunking up and Doubling up! 2 queen beds, 3 or 4 people in the room -- $750
If you are room/bed sharing, who are you traveling with? Name + email please. :)
Your answer
Preferred Payment Method - 50% due upon registering. 100% due after March 27, 2022
Choose
Venmo @ann-fancy
Paypal @ ann.fancy@gmail.com
Check or Cash
Special Dietary Needs?
*
Vegetarian
Vegan
Gluten-free
None
Dairy-Free
Other:
Required
Anything else you need me to know?
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
