Registration:

Thank you for your interest in attending a Scrapper’s Hideaway retreat.

Registration Form

Name:_________________________________________________________________________________

Address:_______________________________________________________________________________

City:__________________________________________________________________________________

State: _______________________Zip:________________________________________________________

Phone:________________________Cell:_____________________________________________________

Email:_________________________________________________________________________________

Retreat Date:____________________________________________________________________________

Please list any dietary needs that you may have:

_________________________________________________________________________________

_________________________________________________________________________________

Please list an emergency contact for you while are at the retreat:

_______________________________________________________________________________________

_______________________________________________________________________________________

 Please list the name/names of your friend or friends attending that you would like to room with:

_______________________________________________________________________________________

_______________________________________________________________________________________

If you are the person eligible for the discount, please list friends here:

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

NOTE: Friends Must be listed at time of registration and paid in full 30 days prior to event. You will receive your refund when you check in.

Please print form and send form with registration fee to:

Scrapper’s Hideaway

1604 Edelweiss Dr.

Cedar Park, Tx 78613

Check or money order payable to Scrapper’s Hideaway. Balance due no later than 1 month before the retreat.