Deeper Water Registration
Friday, October 25 through Sunday, October 27, 2024
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
When did you attend Deep Water?
*
Please Select
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
What DW group do you attend?
*
Please Select
Newberg (Nate's House)
Newberg (North Valley
Newberg (Tim's House)
Portland
Tualitin
Other
I do not attend
How often do you attend?
Please Select
Almost always
Most of the time
Weekend Anticipation
What do you hope to get out of the weekend?
*
What fears or reservations do you have about the weekend?
*
Are there any other things that you would like staff to know about you before the weekend begins?
*
Travel Accommodations
A staff member will work to coordinate any carpool and travel arrangements at least three days prior to the weekend.
Would you be interested in carpooling?
*
Yes
No
Other
Would you be willing to drive?
*
Yes
No
Travel Needs
Dietary Preferences
Please let us know your dietary preferences/needs. The retreat center where we will be staying, Tillikum, is very accommodating in regards to dietary preferences.
Dietary Preferences
Vegetarian
Vegan
Gluten free
Dairy Free
We are able to accommodate the following medical dietary restrictions:
No Eggs
No Peanuts
No Sugar
No Tree Nuts
Pescatarian (eat fish; no other meat)
No Beef
No Pork
No Soy
Other
Other dietary needs
Medical Information
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone
*
Please enter a valid phone number.
Please list any known health conditions or allergies
Your age
*
Payment
Please let us know how you will be paying today. You have the option of either paying in full now or making the deposit (and paying the remainder in full at the start of the weekend).
Payment Amount
*
prev
next
( X )
Deposit
$
100.00
Pay in Full - Early Bird Pricing
Rises to $300 on October 12
$
275.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Expiration Month
Expiration Year
Submit
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