Registration Form--Knit Maine

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
Should be Empty:

Registration Form

Room Choices