AQR's Retreat Arrival Form - Fall 2023

This form is to be completed by ALL attendees for our Fall Retreat. This is required for every event so we have the most current information. Thank you! We appreciate your understanding.

Full Name (First, Last)*

Email address*

Phone Number (cell)*

Emergency Contact Name*

Emergency Contact Phone Number*

Please list any Food Allergies we should know about. (Please not that this note special request but medical allergies that if ingested will cause harm.)*

Does the Allergy listed require medical attention if consumed or contacted?*

If you have medical dietary restrictions, it's imperative that you complete the Retreat Center's Form at the top of this page. Click the link ABOVE, and fill out the form then return it to teamAQR@amysquiltroom.com Did you do this?*

Do you Require Any Special Needs we need to know about? *

Requested Sewing Mates (3-6 per table) If none, please respond NONE/ANY. We will do our best to honor your request but no guarantees. *

What Size Shirt do you wear/prefer?*

Do you plan to leave Retreat early? Regular Check out of your room is 10am on Monday. Please list the day and time you expect to leave.*

Would you like to schedule a Massage? *

If Massage, Select a TABLE Massage Duration for THURSDAY, September 21st *

If Massage, Select a CHAIR Massage Duration for SATURDAY, September 23rd *

If Massage, Select a CHAIR Massage Duration for TUESDAY, September 26th (Take 2 Participants Only) *

I am Registered for*

Any Additional Comment about your Registration

GET MEDICAL DIET REQUESTS/FOOD ALLERGY FORM HERE

Return Completed form to teamaqr@amysquiltroom.com

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Contact Us

Amy's Quilt Room
20 West Penn Street,
Uniontown, PA 15401
Call us now: (724) 434-9987
Email: info@amysquiltroom.com
Click here for our store hours.

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AQR's Retreat Arrival Form - Fall 2023

GET MEDICAL DIET REQUESTS/FOOD ALLERGY FORM HERE

Return Completed form to teamaqr@amysquiltroom.com

Site Links

Contact Us

AQR's Retreat Arrival Form - Fall 2023

GET MEDICAL DIET REQUESTS/FOOD ALLERGY FORM HEREReturn Completed form to teamaqr@amysquiltroom.com

Site Links

Contact Us

GET MEDICAL DIET REQUESTS/FOOD ALLERGY FORM HERE

Return Completed form to teamaqr@amysquiltroom.com