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Women’s Wellness Weekend Registration
Melissa Church
2022-03-11T20:23:22-05:00
Women's Wellness Weekend Registration Form
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Name
Phone number
E-mail
Mailing Address
Emergency Contact Name and number
Dates to Attend
(Please select all or individual dates.)
Friday, June 17th
Saturday, June 18th
Sunday, June 19th
Would you like single or double occupancy?
Please check one.
Single Room
Double Room
N/A
Linens
Which do you Prefer? Please check one.
Bring your own sheets, pillowcases & towels.
Provided by facility. Add $15 to invoice.
Optional: Would you be interested in a massage during the weekend? Additional charges would apply for the therapist.
optional
no
15 minutes
30 minutes
Do you have any dietary restrictions or allergies?