Brunch with St. Nicholas

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1 Welcome

2 Price

3 People in your group

4 Participant Info

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Dietary Restriction(s)	No Dietary Restrictions Gluten Free Dairy Free Nut Allergy Soy Allergy Egg Allergy Vegetarian Other (See Diet Notes)
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5 MEDIA RELEASE FORM

Media Release Form	I, the undersigned, grant Maryville Retreat Center, its representatives, and employees the right to take photographs and/or video recordings of myself and/or my child(ren) in connection with activities at Maryville Retreat Center. I authorize Maryville Retreat Center to use, reproduce, and publish these images and/or videos in print and digital media for promotional, educational, and fundraising purposes.
Name(s) of Minor(s) (if applicable):
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6 Security Check

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7 Payment

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By submitting payment, you authorize Maryville Retreat Center to send instructions to the financial institution that issued your card to take payments from your card account in accordance with the terms of Maryville Retreat Center's agreement with you.

Guest 1		First Name* Last Name* Email*
Guest 1		First Name* Last Name* Email*