Summer Retreat Form 2023 Tucson,AZ

Full name*

First NameLast Name

Preferred name

Nickname

Birth Date*

DayMonthYear

Mailing Address*

Street Address

Street Address Line 2

CityState

Post CodeCountry

E-mail*

Cell Phone Number*

Emergency contact*

First NameLast Name

Emergency contact phone number*

Health Details

In order for us to best serve each participant on the retreat, please answer the following questions. All answers will be kept strictly confidential.

Please answer the following questions.*

	Yes	No
Do you have or have you ever had any physical health problems, eg. diabetes, epilepsy, high blood pressure?*
Do you have or have you ever had any mental health problems, eg: anviety, depression, PTSD?*
Are you now taking any prescribed medication?*
Do you have muscle or joint problem that could worsen by a change in your physical activity?*
Do you smoke?*
Do you know how to swim?
Are you okay to participate in water activities?
Are you okay to participate in hiking activites?

If you answered "Yes" to any of the questions above, give details of all occurrences. Include the following: dates, frequency, type, amount etc below

Do you have any dietary requirements/allergies?

Participation Details

In order for us to best serve each participant on the retreat, please answer the following questions. Answers may be shared to enhance our networking and sisterhood activities.

Type a question*

	Yes	No
Do you own a business?*
Do you want to spotlight your business or service during the retreat?
Would you like to extend an offer or discount to the retreat attendees?*

If you answered "Yes" to a owning a business. Please share with us your business name, description, social media and any details to describe your business and services. We would like to share this info with the retreat attendees.

If you answered "Yes" to extending an offer or discount to the retreat attendees. Please share with us your offer or discount details.

Travel Details

In order for us to best serve each participant on the retreat, please answer the following questions. An Encore Events & Travel representative will follow up with you to best help.

Type a question*

	Yes	No
Do you need help booking your flight?*
Do you need help booking your ground transportation?
Do you want to extend your vacation?
Do you need help booking your hotel room?

If you answered "Yes" to any question in the travel details. Please share with us how we may best help you with your travel to Tucson,AZ.

If you have any questions that you wish to discuss prior to participating in the retreat, please do so before committing yourself to the program.

I realize that retreats held by Live Love and Party | Encore Events & Travel require my mental and physical health and I certify that I am fit to undertake it.

I understand there is a $100 non-refundable deposit due by 31 May 2023, and the remainder of my investment is due by 30 June 2023.

I understand my total investment for the Summer Retreat is $450 per person.

I understand my retreat investment includes: welcome amenities, premium swag bag, group transportation, group apparel, group activities and more!

I understand this does not include any souvieners, hotel room, food and beverage and any other purchases outside of the retreat.

I understand that I am responsible for my lodging, airfare and ground transportation to and from the airport if applicable.

I understand that I am responsible to ensure I have a proper and valid passport and/or government identification to travel.

By attending the retreat, you waive and release any claims you may have related to the use of recorded media of you at the event, including, without limitation, any right to inspect or approve the photo, video or audio recording of you, any claims for invasion of privacy, violation of the right of publicity, defamation, and copyright infringement or for any fees for use of such record media.

You understand that all photography, filming and/or recording will be done in reliance on this consent. If you do not agree to the foregoing, please do not attendee the retreat events.

Event payment may be submitted via CashApp, Venmo, Zelle, Invoice with AfterPay. Any event payments recieved via invoice are subject to a 6% service fee.

Signature*

Thank you.

Our founder, Tyra McGary, will contact you to book your place upon acceptance of your application and submission of the required non-refundable deposit. Text your questions to 985.517.7999 for an immediate response.

A Journey of Self Reconnection Retreat