Registration Form for OvernightNovemebr 19- Novemebr 21, 2021Workshop November 19-21 - Overnight PERSONAL INFORMATION Name * Address * Address Address Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Phone * Email * Diet * Notice that your registration will only go through once you click SUBMIT. The payment can only be processed by accessing the PAYPAL BUTTON separately on this page.The prices below include the registration fee and meals from supper on Friday, November 19 until noon meal on Sunday, November 21. A surcharge will be added for credit card and PayPal payments. If you prefer to complete your registration through PayPal make sure you proceed to click on the PayPal button once you have submitted all your information. $150.00 (+ $3.55 cc fee) = $153.55 (Full Weekend overnight)COVID REQUIREMENTSWelcome to our Retreat Center. Before completing your registration or confirming your reservation for your overnight accommodations, we would like to make you aware of our policy regarding protection against possible transmission of Covid-19 or any other communicable disease. In view of the rapid and intense spread of Covid-19 and its variants and taking into the consideration the protection we may wish to provide to the members of our staff, our sick and elderly Sisters at the Provincial House, as well as any other visitors, to the chapel on the premises, we request that you: __ Fill out our Covid Waiver regarding communicable diseases __ Present a proof of full vaccination OR __ Present a recent negative Covid-test result. (Within 3 days) If, shortly before the event at our Retreat Center, you experience symptoms or have been in contact with someone that has symptoms or has confirmed positive Covid test-results, we ask that you cancel your reservation. We are grateful for your cooperation. Enjoy your stay and the peaceful atmosphere in and around the Schoenstatt Shrine. Schoenstatt Sisters of MaryCOVID WAIVER RELEASE OF LIABILITY AND ASSUMPTION OF RISK Signature * Clear Print Name and Date * COVID-19 IMMUNIZATION OR TESTING INFORMATIONPlease provide the following information before completing your registration. If you are providing a test result, please present that documentation upon arrival and write in this form the estimated date of PCR test.Name * Name First First Last Last DOB * Date(s) of vaccination injection(s) + Type of vaccine Date(s) of vaccination injection(s) + Type of vaccine Date of Covid-19 test prior to event (Please present result upon entering the Retreat Center building! Thank you!)Date of Covid-19 test prior to event (Please present result upon entering the Retreat Center building! Thank you!) If you are human, leave this field blank. Submit Registration optionsFull Weekend overnight $153.55 USD
