Register Field asterisks [*] are required fields. A copy of your waiver and form submission will be emailed to you after it’s submitted. Name(Required) First Last Email(Required) Phone(Required)Address(Required) Street Address Address Line 2 City State*AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Food Allergies?(Required)Do you have food allergies?*YesNoSpecial Accommodations Needed?(Required)Special Accommodations Needed?*YesNoFood AllergiesSpecial AccommodationsIs there anything you’d like for us to know about you that will make your retreat more comfortable and meaningful?What is your greatest superpower?Waiver of Liability - The Blue Blanket Inc.*(Required) I fully understand and agree to the below terms.I, the undersigned, hereby waive and release, indemnify, hold harmless, and forever discharge The Blue Blanket Inc. and its agents, employees, officers, directors, affiliates, successors and assignees, partners, coaches, teachers and trustees of and from any and all claims, demands, debts, contracts, expenses, causes of action, lawsuits, damages and liabilities, of every kind and nature, whether known or unknown, in law or equity, arising from or in any way arising to my participation in any of the events or activities conducted by, on the premises of, or for the benefit of The Blue Blanket Inc. I acknowledge there may be risks associated with physical activities, travel, and attendance at The Blue Blanket Inc. events, and that while those risks are minimal, they are nonetheless real. These include but are not limited to risks associated with food-borne illnesses or allergic reactions, walking on lawns, gravel driveways and dirt paths, bending and reaching, sitting for long periods of time, and so on. I acknowledge that I am participating in The Blue Blanket Inc. event voluntarily, and all risks have been made clear to me. Additionally, I do not have any conditions that will increase my likelihood of experiencing injuries while engaging in any of the activities associated with The Blue Blanket Inc. I further acknowledge that in the event of any accident, injury, illness, common sense first aid assistance will be offered, and then professional medical assistance will be offered immediately from local providers in the immediate area, and that I am 100% responsible for any professional care that is required. I acknowledge that I am assuming all risk and responsibility for my personal health and safety while on ouEngs in Asheville, N.C., and while being transported to and from The Blue Blanket Inc. or any of its Retreat locations. If the Retreat is not filled up by April 30 2023, it will be canceled and full refunds will be given, so please purchase travel insurance if you will be traveling by plane. No refunds will be given under any circumstances after April 30, 2023. By signing below I forfeit all rights to bring a suit against The Blue Blanket Inc. for any reason. In short, I acknowledge that I am assuming all risk and responsibility for my personal health and safety while at this Blue Blanket Inc. event.Signature*(Required)Please sign your name below.Payment InformationCredit Card(Required) American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Security Code Cardholder Name Registration Amount(Required) Price: Total registration amount charged.CAPTCHACommentsThis field is for validation purposes and should be left unchanged.