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YSP Lake Tahoe Adventure Retreat Application
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* Indicates required question
First Name
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Your answer
Last Name
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Your answer
Email
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Your answer
Phone Number
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Your answer
Birthdate
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MM
/
DD
/
YYYY
Sobriety Date
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MM
/
DD
/
YYYY
Tell us a little about yourself, who are you and what makes you tick
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Your answer
Why do you want to come on this retreat?
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Your answer
What are you hoping to take away from this experience?
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Your answer
Do you have any physical limitation that would prevent you from hiking, walking, boating, or kayaking?
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Yes
No
If you answered yes, please list limitations below
Your answer
Where are you traveling from?
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Your answer
How will you get to the retreat?
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Fly
Drive
Will you need transportation from Stateline, NV to the Retreat location?
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Yes
No
Maybe
Which accommodations are you interested in? Select all that apply but feel free to specify your preference in the comment section below!
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Private Room: Queen Bed w/ Private Bathroom: $3,100
Private Room: Queen Bed w/ Shared Bathroom: $2,900
Shared Room: Queen Bed w/ Private Bathroom: $2,700
Shared Room: Queen Bed w/ Shared Bathroom: $2,500
Shared Room: Twin Bed w/ Shared Bathroom: $2,300
Shared Room: Full Bunk w/ Shared Bathroom $2,100
Shared Room: Twin Bunk w/ Shared Bathroom $1,900
Required
Are you attending by yourself or with a friend?
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Rolling solo
Coming with a homie
If attending with a friend and wish to share the bed, please list the name of the additional person
Your answer
Do you plan to pay in full or payment plan? (Your answer has no bearing on who is selected for the retreat)
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Pay in Full
Payment Plan
Is there anything else you would like with us to know?
*
Your answer
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