Chalice Women's Retreat Survey/Registration

Please fill out this form: your input is so valuable to us, thank you. Then click submit.

Name

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Email

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This address will receive a confirmation email

Phone

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Thank you for your interest in Chalice's Women's Retreat. Given the COVID considerations, please answer the following questions:

How likely are you to attend the retreat?

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Please select one option.

Sounds great, but it depends on the prevalence of Covid & flu in March I really want to attend, but it will depend on the size of the group and other Covid precautions Yes, please consider this my registration. I definitely plan to be there - barring unforeseen events, like getting sick

Are you comfortable sharing a room?

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Please select one option.

I would only feel safe if I could have my own room I would gladly share a room with specific people in my pod (enter names of people in next question) I am comfortable sharing a room

Please share names of those in your Pod

I would attend if masks are optional

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Please select one option.

Yes No

I would attend if masks are required

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Please select one option.

Yes No

Do you need a scholarship, if so what can you afford?

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Do you have food allergies, restrictions, or preferences? Please describe.

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Other Comments or Considerations:

Description

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