Retreat application

Please print out this form, fill it out and mail it to: Grandma’s Spinning Wheel, 6544 E. Tanque Verde Rd., Suite 150, Tucson, AZ 85715 OR you may scan your filled out application and email it to: spinningramma@aol.com. You might also prefer to call us with your credit card information rather than send it via email.

Registration form: SHEEP THRILLS V

Full Name:_______________________________________________________________

Mailing Address: __________________________________________________________

_______________________________________________________________________

Phone: _________________ E-mail: ___________________________________________

Please let us know about any special needs or dietary restrictions you may have:

_______________________________________________________________________

_______________________________________________________________________

Registration includes five full meals.

I will be rooming with: ________________________________

Or, surprise me (we choose your roommate)

Retreat fees:  $275.00 which includes 2 nights in the cool foothills of Prescott, 5 full meals, a T-shirt, fiber-related activities and door prizes.  A non-refundable deposit of $100.00 will confirm your reservation, with the balance due by July 1, 2016.  There will be NO REFUNDS unless we can find someone to take your place. If, for any reason, Grandma’s Spinning Wheel has to cancel the event, a full refund will be given to each participant.

Man’s T-shirt size:       sm,          med.        lrg.          XL         XXL         XXXL

Method of payment:        Check           Visa         Mastercard   Card Number___________________________________

Expiration Date: _____________ Security Code: _______

Amount charged: $________________ Authorized signature: _______________________

Cardholder’s printed name: _______________________________

MEDICAL EMERGENCY INFORMATION

Your name: ______________________________________________________________________

Your Doctor’s name & phone: ________________________________________________________

Medication Allergies: _______________________________________________________________

Other Allergies: ___________________________________________________________________

Emergency Contact:

 Name:  _____________________________________ Relationship: __________________________

Phone: __________________________________ Alternate Phone: __________________________