Registration, Maple Brook Memories

Name*

First Last

Phone*

Email*

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Approximate time of arrival*

:

Roughly what time do you plan to check-in, so we can plan dinner?

Name your craft/hobby

Years of experience with this craft

What project are you working on during your stay?

Mark any of the following that would describe you, your interests, and your tastes*

Anything else you would like to add about yourself

Maple Brook Memories, its owner, employees, and helpers will be held harmless against all loss, expenses, damages and liabilities in the event of injury or accident caused by or to retreat registrant or her property. Maple Brook Memories reserves the right to expel anyone from the premises for inappropriate behavior or the intent to do harm to others. Anyone requested to leave will not receive a refund of any portion of their retreat fees. I consent to the use of photos or video in which I may appear, or quotes I make regarding Maple Brook Memories to be used in the marketing and publicity of Maple Brook Memories. If you do not wish to consent, please notify your retreat hostess and Maple Brook Memories will honor your request.

I have read and understand the policies described above for Maple Brook Memories*

I agree

Primary emergency contact name*

First Last

Primary emergency contact relationship*

Primary emergency contact phone*

Secondary emergency contact name

First Last

Secondary emergency contact relationship

Secondary emergency contact phone

Name

This field is for validation purposes and should be left unchanged.

Weekend Registration