Registration Form

* Required fields
Name *
E-mail Address *
Requested Weekend *
Alternate Weekend
Address *
Home Phone
Cell Phone *
Arrival Time
Friends you'll be cropping with.
Emergercy Contact Person
Emergency Contact Number
How did you hear about us?
Selections
Weekend Retreat ......................$225

Extra Night - Thursday...............$45

Extra Night - Sunday..................$45

Day Cropper - Friday..................$45

Day Cropper - Saturday..............$45

Day Cropper - Sunday................$45

Whole Place ..............................$1950
Whole Place Extra Night add-on......$200
Whole Place Weeknight ................ $500
Guest 15 ......................................$50
Guest 16 ......................................$50
Guest 17 ......................................$50
Event Facility Rental .....................$200
Personal Message:
Discount Code
Total Amount *
*
I have read and agree to the Cancellation Policy
Payment Information *
$65 Individual Deposit (Balance due 30 days prior to check-in. Your credit card will be automatically charged)
$300 "Whole Place" Deposit (Balance due 45 days prior to check-in. Your credit card will be automatically charged)
Payment in Full
Payment Type *
Certified Funds (Money Order, Cashiers Check, etc.)
Personal Check (see mailing address below)
Master Card
Visa
Card Number
Exp Date
3-digit security code (from back of card)
Name as it appears on card
Billing Address if different from above
*
I agree and hold harmless San Diego Scrap Inn, its owners, and the Property Owners of the premises of San Diego Scrap Inn, from any harm or damage which may occur or may have occurred at a San Diego Scrap Inn Retreat weekend. I understand and agree that San Diego Scrap Inn will not be responsible for any lost or stolen goods. I have read and agree to, the policies listed on the San Diego Scrap Inn website.

I have read and agree to the Privacy Policy *

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Our mailing address is:      PO Box 1594, Poway, CA 92074