Date with the Muse Writers' Retreat
Application Form 2016
Full Name
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Telephone Number (Including Area Code)
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E-mail Address
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I am interested in:
What's the best thing that's happening in your writing these days?
Your answer
What's the hardest thing?
Your answer
What project(s) are you currently writing or thinking of writing?
Your answer
What do you want to get most out of this retreat?
Your answer
What has made past writing experiences a success? (workshops, classes, retreats, etc.)
Your answer
What has made past writing experiences a FLOP?
Your answer
How did you find out about this retreat?
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Participant Agreement
Please read the Retreat Participant Agreement for: "Date with the Muse Writing Retreat" Reservations:

A $300 deposit per person will secure space on a first come basis, with the rest of the balance due one month before the “Date with the Muse Writing Retreat” (the “Retreat”).

Late registration: Retreat participants may register a month before the Retreat, space permitting. However 
payment in full is required at the time of registration.

Retreat Price Includes:

 -Writing: Workshops and interactive exercises-
Accommodations: Rooms in a private home, that does HAVE PETS, all with shared bath.
-Meals: Breakfast and lunch are a la carte and included. Dinner will be out on the town at your own expense. Advance reservations have been made, but are optional.

Retreat Price Does Not Include: 

Round-trip airfare, bus and/or rail transportation to accommodation, passports, meals in transit or outside of the accommodation, any additional excursions, or any items of a personal nature.

Changes: Changes to the itinerary are not anticipated; however, Date with the Muse, LLC (the “Trip Organizer”) reserves the right to make any changes that it determines are necessary, with or without advance notice. Changes in itinerary will not incur extra charges for participants or result in a refund of any portion of the Retreat price.


Cancellations/Refunds: 
All requests for cancellation must be submitted in writing to the Trip Organizer (and received by the dates listed below). Regardless of the reason, cancellations result in additional costs and processing time for the Trip Organizer. As such, all cancellations will be subject to a $50 cancellation fee.The following charges will be assessed for cancellations: More than 90 days prior to program start date: $50 cancellation fee 
89 - 45 days prior to program start date: $250 plus $50 cancellation fee 
Less than 45 days prior to program start date: 100% of trip price.

If the participant leaves the Retreat prior to its conclusion, refunds will not be made for the unused portion of the Retreat. No refunds will be made for any meal, workshop or other activity that the participant misses or decides not to participate in for any reason.

The retreat is subject to a minimum enrollment of six (6) guests. The Retreat Organizer reserves the right to cancel the Retreat prior to departure. If such cancellation is NOT due to circumstances beyond the Retreat Organizer’s control, such as war etc. as set forth below, the Retreat Organizer will refund all payments, constituting full settlement with the participant.

No compensation or refund will be made when cancellation arises before or during the trip from circumstances beyond our and/or our suppliers’ control (force majeure) such as war, strife, civil disobedience, strikes, terrorist activity, adverse weather conditions, fire, natural disasters, etc., unless or until the Trip Organizer is able to recover any Retreat-related sums.

In the event of cancellation arising from circumstances beyond our control as set forth above, Retreat-related sums recovered by the Retreat Organizer will be distributed equitably to the participants after the Retreat Organizer deducts all out-of-pocket costs and related expenses.It is recommended that participants purchase their own trip cancellation insurance. The Trip Organizer is not responsible for expenses, including but not limited to lodging, meals, and transportation, incurred for delays and/or detainments beyond the trip itinerary as a result of circumstances beyond our and/or our suppliers’ control such as war, etc. as set forth above. Nature of Retreat: 
This Retreat is writing-based.

Accordingly, participants are strongly encouraged to fully attend the writing workshops provided. All participants are encouraged to approach the Retreat with a spirit of openness and adventure.The nature of the Retreat is not suitable for children or substance use or abuse.

Medical Insurance: Each participant is responsible for checking with their current health insurance provider and insuring that they have adequate medical coverage. Participants must carry insurance documentation while on the Retreat.

Photographs/Videotapes: The Retreat Organizer will be photographing and videotaping parts of the Retreat. The Retreat Organizer reserves the right to use any such photographs/videos in its advertising, displays, publicity materials, and publications without obtaining further consent from any participant. Each participant releases the Retreat Organizer and its representatives from any liability in connection with any such use of such photographs and videotapes.

Release/Responsibility: 
The participant, by agreeing to this Retreat Participant Agreement, agrees that the Retreat Organizer and its representatives, except for their gross negligence or willful misconduct, shall not be held liable for any injury, damage, loss, delay or irregularity that may be occasioned for any reason, including, but not limited to any defect in a vehicle, the acts or default of any company or person engaged in conveying a participant, acts of God, terrorism, acts of war, or detention; delays or expenses arising from quarantine, strikes, thefts, pilferage, civil disturbances, government restrictions or regulations, accidents by aircraft, boat, bicycle or motor vehicle, or in any restaurant or accommodation; failure of any means of transportation to arrive or depart as scheduled or changes in transit, or villa services; missed airline or other transportation connections; or for additional expenses resulting from changes in exchange rates, tariffs, or itinerary. The participant agrees to assume all risks associated with the Retreat and agrees that no liability will attach to the Retreat Organizer, its employees or agents, or to any member of the trip in respect of death, personal injury, illness or delay of the passenger, or for any loss of or damage to the property (including luggage) of the participant during the course of the Retreat, howsoever caused.

By agreeing to this Retreat Participant Agreement, the participant releases the Retreat Organizer and its representatives from any such responsibility or liability, except as hereinabove set forth. The liability of common carriers is generally limited and, therefore, it is suggested that participants purchase their own cancellation, property damage (including luggage), and accident insurance. For the benefit of everyone on your trip, the Retreat Organizer reserves the right to accept or reject any Retreat participant at any time without liability, and in the event it determines, in its sole and exclusive discretion, that a participant is disruptive to the harmony of the Retreat, it may without any obligation to pay a refund or any other amount whatsoever, expel such participant from the Retreat. 

The Retreat Organizer will have no responsibility or liability for any participant who leaves the Retreat prior to its conclusion or for any activity undertaken by any participant which is not included on the Retreat itinerary.I

have read and understand the foregoing Retreat Participant Agreement for: "Date with the Muse Retreat" and, by making my advance payment as set forth above, agree to the terms thereof.*

Deposit $300
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