<p> ***REGISTRATION FORM*** Flatwoods Days Hotel and Conference Center Complete and return top page to: Carrie Ford 18 Poplar Hill Drive Charleston WV 25311 (Checks payable to Carrie Ford)</p><p>O April 21-23, 2017 O September 22-24, 2017 Name:______Address: ______City: ______State: ______Zip: ______Phone: ______Email: ______(Confirmation & Updates will be sent via email if provided) Room Mate(s): ______Indicate Package choice: Our weekend package includes lodging, around the clock cropping during event, tshirt (if registered prior to cut off date), door prizes, grand prizes, continental breakfasts (for each night stay), 3 snack breaks (Fri eve/ Sat am/ Sat eve), access to all hotel amenities, hotel fees, taxes and gratuities. Weekend package with 2 nights Lodging (Friday/Saturday): Quad $185.00 per person (deposit Occupancy $92.50) Triple $195.00 per person (deposit Occupancy $97.50) Double $205.00 per person (deposit Occupancy $102.50) Single $285.00 (deposit $142.50) Occupancy</p><p>Weekend package with 1 night Lodging (Friday OR Saturday): Indicate night:______Quad $140.00 per person (deposit Occupancy $70.00) Triple $150.00 per person (deposit Occupancy $75.00) Double $160.00 per person (deposit Occupancy $80.00) Single $200.00 (deposit $100.00) Occupancy</p><p>***Add Thursday Night (Early Bird arrival): Quad Additional $27.50 per person Occupancy Triple Additional $36.67 per person Occupancy Double Additional $55.00 per person Occupancy Single Additional $110.00 Occupancy</p><p>Weekend package Local Non-Lodging: Local non- $100.00 (deposit $50.00) lodging Tshirt Size:______****Registration must be received by date indicated below in order to receive a tshirt. Registration received after that date will not include a tshirt due to ordering and processing times.*** April: 4/7/2017 September: 9/8/2017</p><p>Crop Room seating: Each person will have their own table. Please indicate who you would like to sit closest to:______</p><p>I have read and understand/agree to the attached cancellation policy: ______(registration cannot be processed without signature)</p><p>Please note***Balances due in full by: April retreat: 4/7/2017 September retreat: 9/8/2017</p><p>Cancellation policy: </p><p>April 2017: Cancellations made prior to 3/31/2017 will receive a full refund. Any cancellation made between 4/1/2017 to 4/7/2017 will be subject to a $15 cancellation fee with all other monies paid refunded. Cancellations between 4/8/2017 to 4/17/2017 will be subject to a $50 cancellation fee with all other monies paid refunded. There can be NO refunds given for cancellations made after 4/17/2017. There will be no refunds given for “no shows”.</p><p>September 2017: Cancellations made prior to 9/7/2017 will receive a full refund. Any cancellation made between 9/8/2017 to 9/15/2017 will be subject to a $15 cancellation fee with all other monies paid refunded. Cancellations between 9/16/2017 to 9/19/2017 will be subject to a $50 cancellation fee with all other monies paid refunded. There can be NO refunds given for cancellations made after 9/20/2017. There will be no refunds given for “no shows”.</p><p>Children ages 13 and up are permitted as a fully paid attendee as long as accompanied by a fully paid adult attendee.</p><p>Questions? Feel Free to contact Carrie directly at [email protected] or call/text: 304-437-3850</p>