Surfrider Foundation Pacific Northwest Conference 2013

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Thanks for your interest in participating in this year's Pacific Northwest Conference in Westport, WA, September 20-22. Please fill out and submit this short form to help us make arrangements for your accommodations. All complimentary arrangements will be handled directly by Surfrider staff and will include: 2 nights lodging in Westport, WA, Friday night welcome reception/BBQ at Todd Fischer Art Gallery, Saturday/Sunday Breakfast and Saturday lunch.

First and Last Name *

Chapter Name *

Phone Number and Area Code *

Email Address *

Are you staying at Hotel/Need lodging accomodations *

Yes

Option No

Are you staying Friday night *

Yes

Are you staying Saturday night *

Yes

My Hotel Room Sharing Preference is *

Room with a friend or known chapter member

Room with anyone from any chapter (same gender)

Room alone

If rooming with a friend or known chapter member, please type in their name here *

Room/Bed Preference *

Single King

Two Queens

Pet Friendly Room *

Yes

Any food Restrictions *

Anything goes omnivore

Vegetarian

Vegan

Other:

Submit

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