Instructions
to register
for Sattva
Either:
Complete registration form, print this screen,
and mail with check payable to:
Cedar Ridge or send credit card information
to:
Cedar Ridge
PO Box 296 Vernonia, OR 97064
Or
Complete and submit online with credit card
information. You will receive confirmation
of your registration within 10 days of receipt.We
respect your privacy immensely and will
not share your personal information or use
it for anything other than Women's Weekend
Away! related communication.
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| First
Name:
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Last
Name:
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| Street
Address:
|
Apt./Suite
#
City:
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| State:
Zip:
|
Country:
|
| Home
Phone:
(include area code)
|
Work:
(include area code)
|
| Cell:
(include area code)
|
Fax:
(include area code)
|
Best
phone # to reach you
Best time to reach you:
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Gender:
Female
Male
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| e-mail:
|
Occupation:
|
Preferred
method of contact:
|
How
did you hear about this retreat?
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Sleeping
Arrangements
The beds are very comfortable with
nice linens. Many are bunk beds.
Therefore, we would like the following information
in order to most comfortably accommodate everyone. |
Are
you coming with friends/family?
Yes
No |
If
so, how many total are in your group?
|
| What
are their names?
|
Type more names here
|
| Do
you occasionally snore?
Yes
No |
Would
sleeping on a top bunk be possible for you?
Yes
No |
|
*Health
Information
Cedar Ridge Retreat Center is located
in a rather rural community and there are
no health care professionals on staff. |
| Are
there any medical situations or physical limitations
we should know about?
Yes
No |
If
so, please list:
|
| Dietary
Restrictions:
Yes
No
|
If
so, please list:
|
| Medical
Doctor:
|
Phone
Number :
(include area code)
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| Emergency
Contact Person:
|
Phone
Number :
(include area code)
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