Winter Hideaway Winter Hideaway for Ladies Only Registration Form OK Question Title * 1. Name and Phone Number OK Question Title * 2. Would you prefer a single, private room? Yes No Other (please specify) OK Question Title * 3. If you want to room with someone, who would you like to room with? OK Question Title * 4. All participants are expected to be professional and respectful to all participants and staff at all times. We reserve the right to ask participant(s) to leave the premises immediately if they are unprofessional in any way. In these cases, the participant(s) will not be allowed to attend any future events unless approved by the administrator. ... The only people allowed in any of the events are registered participants and guests who have been invited by the host. ... We are not responsible for any participant's belongings or safety. ... I have read and agree with this statement. Agree Disagree OK Question Title * 5. An $80 Registration fee is due on 12/31/21 unless other arrangements have been made with the host. Please pay all fees on Dr. Elaine's Event Page, Cash App, PayPal, ApplePay, Venmo or Zelle. Fees are nonrefundable, but are exchangeable before 1/15/22. All fees must be paid in full by 2/1/22. I have read the fee information and I agree with the terms. Yes No OK Question Title * 6. Do you have any food allergies? Yes No OK Question Title * 7. If you have food allergies, please list them here. OK Question Title * 8. Due to Covid-19, everyone will be prescreened before the event. Please arrange to have a rapid covid test 24-48 hours before you arrive. *** I have read and agree with the Covid-19 rules. Yes No OK Question Title * 9. Emergency Contact: Name, Relation & Phone Number OK Question Title * 10. Please let us know how you heard about the "Invitation Only" Hideaway Event. If someone invited you, tell us who, so that we may thank them personally. OK DONE