2023 Workshop Retreat Dietary Restrictions

Thank you for registering for a 2023 PLAYA Workshop Retreat or Special Weekend. We will provide meals for your program so pelase incldue any dietary restricitons for any guests below.

* Dietary restrictions are not required for self-directed residencies except for the Birding and Dark Skies Special Weekends for which meals will be provided.

Guest #1 Information

Which Workshop or Special Weekend are you attending?

Geology of Oregon's High Desert- Sept. 14-17

Oregon Outback Plein Air- Sept. 21-28

Dark Sky Special Weekend- Oct. 12-16

Writing at the Intersection of Nature and the Human Experience- Oct. 5-10

Name

First Name

Last Name

Cell Phone

Verify Email

Emergency Contact ( Name, phone #, email, address)

Please list the name, phone number and email address of an emergency contact (preferably someone not attending with you)

Is there anything else we need to be aware of to make this a safe and accessible experience for you?

Guest #2 Information Please provide information for the guest attending with you. If you prefer we contact them directly for this information please check the appropriate box.

Please provide information for the guest attending with you. If you prefer we contact them directly for this information please check the appropriate box.

Guest #2 Name

First Name

Last Name

Guest #2 Email

Verify Email

Please contact Guest #2 directly for the below information

Yes

Guest #2 Cell Phone

Guest #2 Emergency Contact (If different from Guest #1)

Please list the name, phone number and email address of an emergency contact (preferably someone not attending with you)

Guest #2- Is there anything else we need to be aware of to make this a safe and accessible experience for you?