AAMBC WRITERS RETREAT REGISTRATION MARCH 13-16, 2025 CABIN WILDERNESS AREA Leave this field blank REGISTRANT INFORMATION Name Email Phone Number Address EMERGENCY CONTACT INFORMATION Emergency Contact Name Emergency Contact Phone Number Relationship to Emergency Contact WRITING BACKGROUND What genres do you write in? (Select all that apply) Fiction Non-Fiction Poetry Screenwriting Playwriting Memoir Other (please specify): If other, please explain How long have you been writing? Less than 1 year 1-3 years 3-5 years 5-10 years More than 10 years Please provide a brief description of your writing experience and any notable achievements: What are your primary goals for attending this retreat? (Select all that apply) Improve writing skills Network with other writers Find inspiration Get feedback on current projects Learn from industry professionals Other (please specify): If other please specify What specific topics or areas would you like to see covered during the retreat? Do you have any dietary restrictions or preferences? (Select all that apply) Vegetarian Vegan Gluten-Free Dairy-Free Nut-Free None Other (please specify): If other please specify LODGING AND ACCOMMODATIONS Do you have any allergies or medical conditions we should be aware of? Do you require any special accommodations? WORKSHOP PREFERENCES Are you interested in participating in one-on-one sessions with mentors? Yes No Which Package Are You Interested In? Please specify which package below Bronze Package Includes: 1 bunk bed All-you-can-eat breakfast, lunch, dinner, and snacks Access to all classes Amenity kit Welcome gift Silver Package Includes: Queen-sized bed in a shared room All-you-can-eat breakfast, lunch, dinner, and snacks Access to all classes Amenity kit Welcome gift Gold Package Includes: Queen-sized bed in a private room One-on-one sessions with a bestselling author Complimentary welcome champagne. All-you-can-eat breakfast, lunch, dinner, and snacks Access to all classes Amenity kit Welcome gift Diamond Package Includes: King sized bed in a private room Private ensuite bathroom One-on-one sessions with a bestselling author Complimentary welcome champagne. All-you-can-eat breakfast, lunch, dinner, and snacks Access to all classes Amenity kit Welcome gift Sleep-Away Package Includes: All-you-can-eat breakfast, lunch, dinner, and snacks Access to all classes AGREEMENT and SIGNATURE How did you hear about this retreat? AAMBC Website Social Media Word of Mouth Other (please specify): If other please specify Any additional comments of questions? (optional) PAYMENT OPTIONS Payment Method: Credit Card PayPal Check AGREEMENT and SIGNATURE I understand that my registration is not complete until payment is received. You will be redirected to the payment page upon submission of the form. Yes Send