Name *

First Name

Last Name

Cell Phone *

(###)

###

####

Birthday

MM

DD

YYYY

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Do You Have Any Food Allergies or Dietary Restrictions? *

YES

NO

Have you attended any of our previous Well Crafted events? *

YES

NO

I Understand that all monies are NON-REFUNDABLE *

*for any reason, including but not limited to weather, acts of God, etc.

YES

Liability Release *

This agreement releases Well Crafted Retreats from all liability relating to injuries that may occur at the Vision Workshop at April Knight's residence in Mars Hill, NC. By signing this agreement, I agree to hold Well Crafted Retreats entirely free from any liability, including financial responsibility for injuries incurred, regardless of whether injuries are caused by negligence.

I AGREE

Photo/Video Release *

* I hereby grant Well Crafted Retreats the irrevocable right and permission to use photographs and/or video recordings of me on their website and in publications, promotional flyers, educational materials, derivative works, or for any other similar purpose without compensation to me.

I AGREE