Retreat Questionnaire

Thank you for filling out this questionnaire. I realize the personal nature of some of these questions. Please be assured that the completed forms are kept in strict confidence. I, Cory Muscara, am the only person who sees this information. Any information you are willing to provide will be of great help to me in assisting you with common issues that may arise during the retreat and for us to best accommodate your housing arrangements. No record of this questionnaire, other than contact information, will be kept after the course is completed







To help us provide the most appropriate accommodation for you within your selected housing, please answer the following questions. Within our space constraints, we will do our best to honor your request. 

CommuterCabinRetreat LodgeBenson House



YesNoSometimes


YesNo


MaleFemaleTransgender or gender diverse (e.g. gender queer, gender fluid, agender, etc.)


Room for menRoom for women




Informed Consent Agreement

I understand that if for any reason I am unable to, or think it unwise to engage in any of the techniques and exercises discussed and presented during this retreat at Camp DeWolfe, I am under no obligation to engage in these techniques nor will I hold the above named facility or its instructor liable for any injury incurred from these practices.

Yes

Thank you!
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