Toni D'Anca Consulting

Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

Country

(###)

###

####

I plan to stay at The Barnacle Inn *

Yes

No

I prefer a single room if available *

Yes

No

Are you interested in finding a roommate? *

We will do our best to connect you with someone, though it is not a guarantee.

Yes

No

My roommate and I prefer

One Bed

Two Beds

Payment *

A deposit of $1,000 is due with registration. The balance is due by July 5, 2021.

$1,000

$1,850

I plan to pay my deposit by *

Check

Credit Card

Agreement *

Registrations are not transferable. All cancellations must be made in writing and received by July 5, 2021 for a full refund less a $150 processing fee. There is no refund for cancellations received after this date. If you leave the program for any reason, there is no refund for unused services. If the program is cancelled or postponed, we assume no responsibility for participant’s cancelled air tickets or other prepaid transportation arrangements. Should the program require rescheduling due to unforeseen circumstances, all registrations will be moved to the new dates. Cancellations will receive a full refund less the processing fee. By registering for this program, participants specifically waive any and all claims of action against Dennis Patrick Slattery, Willow Young, Toni D’Anca, and The Barnacle Inn for damages, loss, injury, accident, delay, or death incurred by any person in connection with the program. No responsibility is accepted for losses or expenses due to sickness, weather, strikes, wars and/or other causes. In the event it becomes necessary or advisable for any reason whatsoever to alter the schedule or arrangements, such alterations may be made without penalty. If the program is cancelled or postponed by us, due to enrollment level or other unforeseeable circumstances, all fees will be refunded in full. If the program is cancelled or postponed, we assume no responsibility for participant’s cancelled air tickets or other prepaid transportation arrangements. I HAVE READ AND AGREE TO THE TERMS AND CANCELLATION POLICY FOR THIS PROGRAM.

Yes