Retreat Registration Form

Phone(Required)

How your name should appear on your nametag(Required)

Location(Required)

Your tag will show where you are from (City, State/Country). What should your tag say?

Which pronouns do you prefer?

Name of Emergency Contact(Required)

Emergency Contact Phone Number(Required)

Is this your first time attending the Exponent II retreat?(Required)

Your Workshop, Session or Presentation Idea

Roommate Selection

IF you are registering for a Semi-Private (2-person) or Adult-friendly room (4-person), with whom would you like to bunk? (ONLY required for semi-private and adult-friendly registrations)

Additional Information – Please scroll down and hit submit just once to save your form data. Please do not submit this form more than once.

If you were unable to register for your preferred room type, you may note it here and if there space opens up, we will let you know of the option to adjust your registration and payment. You may also share any additional information we might need to know here.

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