Deaf Women's Gathering 2021 Event Registration
Event Timing: March 26-28, 2021
Event Address: 2015 Stony Point Rd, Franklin, KY 42134
Questions? Contact us at deafwomengathering@gmail.com OR text Sara at 502 681 4656
Email address *
First & Last Name *
Street Address *
City, State, Zip *
Birthdate *
MM
/
DD
/
YYYY
Are you: *
Required
What's your t-shirt size? *
What is your dietary restriction? *
Required
Do you have food sensitivity or allergy? If yes, what are your food sensitivity or allergy? *
Do you have any medical issues that we should be aware of? Your answers will be kept confidential.
I understand that only private rooms are available due to COVID-19, to encourage social distancing. Do you have a roommate? *
If you have a roommate, what is her name? Your roommate must list your name on her form response to be assigned to each other.
If you don't have a roommate, would you like us to assign one?
Clear selection
There is only one queen-sized bed in each private room. Would you be willing to bring a cot or air mattress? *
I understand that my spot at the Deaf Women's Gathering is not reserved until my payment of $235 has been received in full. The cost covers the room, crafts, t-shirt, and Friday supper to Sunday breakfast. No payment plans will be accepted. *
I understand that the deadline to pay is February 4th, 2021. A late fee will be charged for payments after February 4th. No more registration or payments will be accepted after March 4th. *
I understand that a negative COVID-19 test is REQUIRED before attending the retreat, to protect the health of the campers. Please book your COVID-19 testing 5 days before the retreat (March 21) to allow for time with lab processing. No rapid COVID-19 testing, since it can be less accurate and have more errors. You can get FREE COVID-19 tests at CVS, or Google search free testing in your area. To book an appointment for COVID-19 testing: https://www.cvs.com/minuteclinic/covid-19-testing *
I understand that if I test positive for COVID-19 right before the retreat, I will immediately inform DWG. Symptoms may appear 2-14 days after exposure to the virus. People with these symptoms may have COVID-19: Fever or chills, Cough, Shortness of breath or difficulty breathing, Fatigue, Muscle or body aches, Headache, New loss of taste or smell, Sore throat, Congestion or runny nose, Nausea or vomiting, Diarrhea. If you have any of the symptoms, please do NOT ATTEND the retreat. If you test positive, you will get a full refund or you can use the money for next year's retreat. *
I understand that I will be paying for the retreat through Paypal only. No checks or paper forms will be accepted this year to reduce the spread of COVID-19. For the security of your electronic payment, please DO NOT SUBMIT your payment while using public wifi (like Starbucks, etc). Please pay on a secure and private wifi, like your personal home wifi. For more information about the security of Paypal, please visit their website at: https://www.paypal.com/c2/webapps/mpp/paypal-safety-and-security?locale.x=en_C2 *
Are you ready to pay? We will email you an invoice of $235 when you're ready to pay. *
Do you have any questions?
Electronically signed by: (first & last name, and date) *
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy