JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Wisconsin Retreat
November 3-4-5 2023
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Let's get to know you!
Before we arrange the rooms, we would like some input. Thank you, Kathy
What is your name?
*
Your answer
Are you allergic to anything?
*
Your answer
Dietary needs
*
Vegetarian
Gluten-free
Vegan
Dairy Free
Other:
Required
If you have any concerns, please state them below:
*
Your answer
Do you need any help carpooling? We can ask for a request from the other participants.
*
Yes, I would love to carpool with someone
No, I got my transportation
Do you consider yourself an Introvert or Extrovert?
*
Introvert
Extrovert
What time are you arriving November 3rd?
*
Your answer
November 5th at noon is our check out time. Our check out procedure is that you are responsible to remove and place the linens including: mat, towels & bedding in the laundry room that is in our hallway.
Do you have any problems with this?
*
No, it's easy
Yes, I have difficulty walking or removing sheets
Required
Do you understand our refund policy? If you require a refund please see details. -->
½ back before July 2023. ¼ August – October. November -
no refund
–
Payment/Transfer fees are not refunded additional.
*
Yes, I do
I will contact you for clarification, 425-220-6283 contact Kathy Milanowski
We are snuggling around a forest, and there are many hiking trails. If weather permits would you like to be part of a morning hike after breakfast?
*
Yes, I enjoy hikes!
No, I would rather do another group activity
You go, I am going to stay back and relax with self-care time
Suites
Please fill this out if you have chosen a Double or Triple Occupancy room. Leave blank for the questions that do not pertain to you.
What is your ideal inside temperature?
Your answer
If you have registered for a double or triple occupancy room, please provide the name/s you would like to room with. If you want Kathy to arrange roommates for you, write N/A
Your answer
How many roommates are you requesting us to find you?
I need one more roommate
I need two more roommates
I have my roommates already
Accommodations with a roommate
Please fill this out if you have chosen a Double or Triple Occupancy room
What concerns do you have with a roommate?
Your answer
Do you snore or talk in your sleep?
Yes
No
Clear selection
Does snoring bother you?
Yes
No
Clear selection
Do you have a CPAP or similar device?
Yes
No
Clear selection
Do you understand there is no smoking/alcohol/drugs on the premise. Please find other accommodations, not inside the building.
*
Yes, I understand
What type of options do I have, contact Kathy Milanowski, 425-220-6283
Do you understand you are liable for any damage to your room?
*
Yes
No
You understand that you are responsible for your own welfare. If any injury or accident occurs you take full responsibility for your care.
*
Yes, I understand and take responsibility
No, I do not want to take responsibility
Please provide medical insurance coverage. If you opted out Kathy will be contacting you.
*
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
