SJW Attendee Questionnaire

Basic Info

Legal Name*:

Badge Name*:

Email*:

Phone Number (To be used to reach you in an emergency only)*:

Payment*

Payment Plan: $50 deposit due now and the remaining $300 due prior to August 1st. Please make installments that work for you and your time of registration. Payment in full of $350 now.

If you would like to contribute to the scholarship fund, please contact registration@submissivejourneyweekend.com.

About You

We want to know who's in our community on the mountain! Is there anything we should know about you (like if you're a nurse/doctor, chef, or have other professional qualifications), any skills you have and might want to share, etc.

Travel Plans

We aren't asking for set in stone plans, but something along the lines of "I'm driving from Baltimore and would like someone to ride with me." or "I'm flying in from Arizona, but can't share a rental car."

Can we share your email to facilitate travel? Yes No

Food Prefences

Do you food have allergies?* Yes No

Do you have medical dietary restrictions?* Yes No

Are you a vegetarian?* Yes No

Do you have other food restrictions we need to know about? Also, if you said yes to diet questions above, please provide any details we need.

Sleeping Arrangements

Do you snore?* Yes No

Can you sleep with a snorer?* Yes No

Do you sleep with a CPAP machine?* Yes No

Can you sleep in a room with a CPAP machine?* Yes No

Can you sleep in a top bunk?* Yes No

Do you usually go to bed before 10 pm?* Yes No

Is there anything else we should know regarding sleeping arrangements?

Medical Information

Do you require any accessibility considerations (for mobility limitations, the cabin is partially accessible and information can be provided).

Do you have any medical concerns we should be aware of?

Emergency Contact Information

Legal Name of Emergency Contact*

Relationship to Emergency Contact*

Phone Number of Emergency Contact*

Does your contact know you will be in Tennessee?* Yes No

Does your contact know you will be at an alternative lifestyle event?* Yes No

Legal Name of Secondary Emergency Contact:

Relationship to Secondary Emergency Contact:

Phone Number of Secondary Emergency Contact:

Does your secondary contact know you will be in Tennessee? Yes No

Does your secondary contact know you will be at an alternative lifestyle event? Yes No