PLAYA | Memoir Retreat Week Oct. 14-19
Please have each person in your party fill this out. If you have accessibility barriers please call Trina or Chelsea at 541.943.3983. Thanks for registering so we can better accommodate you.
First Name
Last Name
Phone Number
Email Address
Full Address (e.g., 47531 Hwy 31, Summer Lake, OR 97640)
Do you have accessibility needs? (i.e. ADA, no stairs, hearing impaired)
Sleeping Arrangements - Most cabins have one queen sized bed.
Who will you be sharing a cabin with?
Dietary Information: If food is being prepared for you at Playa. Please mark if you have a life-threatening, severe food allergy.
Emergency Contact Information (Name, Phone, Address, Email)
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