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PAYMENT INFORMATION

We accept Visa, MasterCard,
American Express and Discover.

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BACKGROUND AND PREFERENCES

MY PURPOSE FOR WANTING TO ATTEND THIS SESSION IS:

I WISH TO ATTEND:

• A SESSION ALONE
• A SESSION WITH ONE OTHER
• A SESSION WITH TWO OTHERS

PLEASE GIVE DETAILS IF YOU HAVE
ALREADY ARRANGED TO ATTEND WITH OTHERS:

MY PREFERENCES FOR THE DATES ARE:

• FIRST CHOICE
• SECOND CHOICE
• THIRD CHOICE

MY MEAL CHOICES ARE:

• VEGETARIAN
• MEAT
• POULTRY
• VEGAN
• FISH ONLY
• FISH OR POULTRY

BREAKFAST SELECTIONS:

• CEREALS
• OATMEAL
• WAFFLES
• EGGS
• BACON, SAUSAGE, HAM
• TOAST, ENG. MUFFINS

PLEASE DETAIL YOUR FAVORITE BREAKFASTS AND YOUR FAVORITE BREADS, CEREALS, AND MEATS:

• FRUIT
• YOGURT
• COCOA
• COFFEE
• DECAF. COFFEE
• TEA
• JUICE

PLEASE DETAIL YOUR FAVORITE FRUITS, YOGURTS, JUICES, AND OTHER DRINKS

WHAT LUNCHEON FOODS DO YOU LIKE THE MOST (PLEASE BE SPECIFIC):

WHAT FOODS DO YOU NOT EAT (PLEASE BE SPECIFIC)?