Registration Form
KNIT MAINE
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
How did you hear about us?
Have you attended a K&YA Retreat in the past? If yes, which one?
Please list any medical concerns/medications. If none, type "None".
Please list any dietary restrictions/requirements. If none, type "None".
Anything else you would like to share?
Please list two (2) Emergency Contacts with Phone
Room Choices
Please make 3 different selections.
Please Select 1st Choice Rooming Option (price is per person for the all 3 nights)
*
Double with Bath $450 per person
Quad with Bath $400 per person
Double (near central washroom) $350 per person
Triple (near central washroom) $300 per person
Dorm (near central washroom) $250 per person
Day Student $225
Please Select 2nd Choice Rooming Option (price is per person for the all 3 nights)
*
Double with Bath $450 per person
Quad with Bath $400 per person
Double (near central washroom) $350 per person
Triple (near central washroom) $300 per person
Dorm (near central washroom) $250 per person
Day Student $225
Please Select 3rd Choice Rooming Option (price is per person for the all 3 nights)
*
Double with Bath $450 per person
Quad with Bath $400 per person
Double (near central washroom) $350 per person
Triple (near central washroom) $300 per person
Dorm (near central washroom) $250 per person
Day Student $225
Rooming together? Please list roommates, If not, you will be assigned to a room.
Are you interested in taking the shuttle bus from Portland to Deer Isle? Selecting Yes or No indicates interest and does not commit you either way.
Yes
No
Submit
Should be Empty: