Retreat Participant Travel Name * First Name Last Name Your Preferred Pronouns * Email * Your Mailing Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * Country (###) ### #### Please list all food allergies/sensitivities or strong dislikes: * Are there any medical / health issues that might affect your full participation during our retreat? * Name of an Emergency Contact not traveling with you * First Name Last Name Emergency Contact's Mobile Phone # * Country (###) ### #### Will you ride in the group shuttle FROM ROME to Le Pianore on 05/04? * YES NO If YES above (group ride FROM ROME): your inbound flight information (date/time/carrier/flight #) Will you ride in the group shuttle TO ROME from Le Pianore on 05/11? * YES NO If YES above (group ride TO ROME): your outbound flight information (date/time/carrier/flight #) Thank you! Your responses have been recorded. If any of your travel plans change, please reach out directly to jwinther@gmail.com
