In order to register for the Writing as a Pathway retreat, please complete the form below.

If you have trouble with this form or have additional questions, you can contact Laura by email at lauradavis@lauradavis.net.

Writing as a Pathway Registration Form

If you have technical difficulties with this form or have additional questions, you can contact Laura’s assistant, Jen, by email at jpeachtree23@gmail.com or call 330-421-0111 (Jen is on Eastern Time and is available most weekdays from 7 am PT/10 am ET until 3 pm PT/6 pm ET.

First Name*
Last Name*
Billing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Postal Address (if different from billing address)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email Address*
Phone Number*
Cell Phone
If we need to contact you, what is the best way to reach you?*
- Text
- Call
- Email
If you prefer to be called, what are the best times to call?
Payment*
- Double Room, deposit: $500
- Double Room, paid in full: $2,400
- Single Room, deposit: $500
- Single Room, paid in full: $3,300
Total
$0.00
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If you are signing up for a double because the singles are all taken, would you prefer a single if one were to become available? (We’ll keep a waitlist for upgrades in case of cancellations).
- Yes please, add me to the single room waitlist.
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If you are signing up for a single because the doubles are all taken, would you prefer a double if one were to become available? (We’ll keep a waitlist in case of cancellations).
- Yes please, add me to the double room waitlist.
Payment Method*
- Credit Card
- Check
Credit Card

MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Would you like to be added to Laura's email list?*
- Yes! Sign me up to get weekly writing prompts from Laura, to receive occasional blog posts, and to stay in touch with future workshops.
- No. I'd prefer not to be added to the list.
- Thanks, but I'm already on Laura's mailing list!
Comments
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