Rose Hill's Peaceful Prairie Retreat
Camper Registration Form
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Email *
Please provide your full name: *
Phone number: *
Are you signing up as an individual or couple, or friend pair? *
Please list the full name of each camper as appropriate. *
What are the tent arrangements we should expect from you (and your partner if a couple or friend pair)? *
Required
What level of camping experience below best fits you? *
What draws you to this experience on the Peaceful Prairie? Please Check All that Apply: *
Required
What, if any, fears or concerns do you have about camping on the prairie? (please list below) If there are none, please state "none." *
Do you have any food or plant species allergies we should be aware of? *
Does your couple partner or friend, if a pair, have food or plant species allergies we should know about? (ignore this question if you are a single camper)
Whom should we contact if there were an emergency? (Please include their name and phone number) *
Do you have any health concerns that we should be aware of? If so, please explain below. *
Please acknowledge the cost of your registration. *
Payment in cash or via check, or Venmo is required. Please list below, the method of payment you plan to employ. Once we have received your registration form, you will receive an email with further instructions. *
Please acknowledge that you understand the following Registration Policy: Campers are not registered until full payment has been received, and a RECREATIONAL ACTIVITY RELEASE OF LIABILITY FORM is signed and returned to lisa@prairieartsyoga.com After submitting this form, you should receive a confirmation email with the FORM attached. Please call Lisa at (308) 672-1114 if you do not receive confirmation within 24 hours of submitting this form. *
Required
Please acknowledge your understanding of the Cancellation Policy: Registered/Paid Campers can receive a full refund until midnight on May 31, 2021, by emailing Lisa at lisa@prairieartsyoga.com. A half refund will be available from June 1, 2021 - midnight on June 12, 2021. No refunds will be issued after June 12th. Cancellations must be in writing and within the time frames listed above. If for any reason, a cancellation is made by the organizer, Lisa Betz-Marquez, a full refund or credit for future services or events will be issued, according to the camper's choice. *
A copy of your responses will be emailed to the address you provided.
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