Spring 2021 Registration (SESSION ONE) Name* First Last My pronouns are:* she/her he/him they/them Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email*Please provide an e-mail address where we can easily contact you. All correspondence, including registration confirmation, further important retreat information and any updates will be sent via email from email@example.com — so it is critical that you have approved our email address. Phone*Housing choiceBecause we want to be as mindful as possible with regard to the COVID-19 pandemic, for 2021, every attendee will have a private unless they are sharing the room with a friend or family member. Every bed is a twin bed. There are no queen beds. I will be sharing my room with friend/family member If you are planning to share a room with friend/ family member Please indicate here:Please provide emergency contact info.First and last name*Phone Number*OPTIONAL INFORMATIONThese questions are OPTIONAL, but are extremely helpful for assigning cottages and shared rooms.BEST WAY TO START THE DAY?BEST WAY TO END THE DAY?WORD(S) TO DESCRIBE HOW YOU HOPE THIS WEEKEND WILL FEEL?If any of the following is important to you, please check all that apply.Bedtime I prefer to go to sleep early and enjoy a quiet cottage in the evenings I am on holiday and enjoy lively conversations by the fireside —no bedtime for me! Cottage size I prefer to be in a larger cottage 5+ people I prefer to be in a smaller cottage 4 people or less Ages I am here for the experience and enjoy sharing space with people of all ages I would like to be with other attendees who are between the ages of: Dietary Restrictions I am vegetarian I am vegan I am gluten-free Other 20-30 30-40 40-50 50-60 60+ Other dietary restriction(s):How did you hear about Squam Art Workshops?Recommendation by a friendSquam NewsletterInstagramFacebookTwitterGoogle SearchOtherIf other, please specify:I have attended Squam previously.NoYesNumber of times attended:Which sessions?ANY OTHER INFORMATION YOU WOULD LIKE US TO KNOW? (if you have a cottage request, please let us know here)Class choicesPlease use the following dropdowns to indicate your FIRST, SECOND and THIRD class choices for each day. For more information on each class and updated class availability please visit: squamartworkshops.com. NOTE: You will have a total of TWO 5-hour classes: one on THURSDAY, one on FRIDAY.THURSDAY - first choice*choose onePortrait of an IconBeginner BriocheTunisian SamplerIntentional BotanicalCombo MamboBoss BriochePlaying with ColorTHURSDAY - second choice*choose onePortrait of an IconBeginner BriocheTunisian SamplerIntentional BotanicalCombo MamboBoss BriochePlaying with ColorTHURSDAY - third choice*choose onePortrait of an IconBeginner BriocheTunisian SamplerIntentional BotanicalCombo MamboBoss BriochePlaying with ColorFRIDAY - first choice*choose onePortrait of an IconBeginner BriocheTunisian SamplerIntentional BotanicalCombo MamboBoss BriochePlaying with ColorFRIDAY - second choice*choose onePortrait of an IconBeginner BriocheTunisian SamplerIntentional BotanicalCombo MamboBoss BriochePlaying with ColorFRIDAY - third choice*choose onePortrait of an IconBeginner BriocheTunisian SamplerIntentional BotanicalCombo MamboBoss BriochePlaying with ColorPayment informationPlease choose from the following options:On campus includes all workshops, evening events, 4 nights lodging, full meal plan (4 breakfasts, 3 lunches, 4 dinners) Off campus includes all workshops, evening events, 3 lunches, 1 dinner (Wednesday)On campus attendee (Standard Week): 1590 USDOff campus attendee: 990 USDThe following options are available for off-campus attendees: 4 breakfasts: 50 USD 3 dinners: 75 USD Due today:A non-refundable deposit fee is required to process your registration. You may also elect to pay the full balance today. - 350 USD Payment by check is preferred. (Once your Registration is submitted, you will be re-directed to a page with payment instructions) You may also elect to pay via PayPal. *ALL attendees outside the USA must pay via Paypal. I have $125 credit from 2020 to apply Choose your payment type:Pay by checkPay by PayPalCancellation policy: No refunds after April 30th, 2021. Deposits are non-refundable and non-transferable. There are no exceptions. All requests for refunds must be received in writing before April 30th, 2021. (You may have someone else take your spot before May 15th, 2021, but we must be notified of all changes). In the case of acts of God, war, disaster or unforeseen circumstances, Soliden LLC reserves the right to reschedule Squam Art Workshops. In the event of a resurgence of the pandemic which requires a cancellation of the event, we will refund ALL monies paid to date, minus a 200 USD admin fee.Release form:* I have read all the above policy information and I agree to assume all risk of personal harm or injury relating to or resulting from my participating in all workshops and activities associated with Squam Art Workshops, and to hold Soliden LLC and its teachers, harmless as to liability for any such harm or injury. Accuracy statement:* I have triple-checked the Registration Form for accuracy and found the information to be true and correct.