R&R Holistic Retreat Room Request Form & Waiver

R&R Holistic Retreat Room Request & Waiver Form

Thank you for choosing to be a guest of R&R Holistic Retreat at Amethyst Retreat Center in Duncannon, PA September 20-24, 2024. Please complete this request form, upon receipt of my confirmation of room availability, you can then submit your payment this reserves your space on the retreat. You may book the room for one guest then add guests if you want more to come with you at a later date within one week of the retreat.
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Which room is your first choice?
If your first choice is booked, which room would be your second choice?
How many in your group?
Select Your Room Rate (Based on how many in your party & your first choice)

RESERVED - ONE GUEST Dragon Fly Room with Private Bath first floor - $875RESERVED - TWO GUESTS Dragon Fly Room with Private Bath first floor - $675 eachONE GUESTS Any Second Floor Room Shared Bath - $380TWO GUESTS Any Second Floor Room Shared Bath - $380 eachTHREE GUESTS Any Second Floor Room Shared Bath - $380 each
What are the names and emails of the people in your party if more than one?
Cancelation Policy: The balance is due to reserve your space on the retreat. You may reserve a room by your self then add guest to your room and pay the balance up to one week prior. There are no refunds, but we can transfer your reservation to someone else. If you are unable to come, let me know as we both can look and find someone to take your place. Refund will occur, but only if we find someone to take your place. Do you understand and agree to the cancelation policy?

Yes, I get that this protects your business and understand.No.
I agree to send payment to Gwen upon her confirmation of room reservation. via VENMO @Gwen-DeYoungStanton, Zelle (908) 797-2745, Check to Gwen Stanton, or Cash.

Yes, I understand this reserves my room. Thank you! .
Do you have any Food Allergy or accommodations or interests or needs?
By this Waiver, I your name assume any risk and my guests, take full responsibility and waive any claims of personal injury, death or damage to personal property associated with the retreat activities organized by R & R Holistic Retreats with Gwen Stanton.

Your Name Your Signature

Date
Should be Empty:

R&R Holistic Retreat Room Request & Waiver Form