Name *

First Name

Last Name

Phone *

(###)

###

####

Date *

MM

DD

YYYY

Media Consent *

I give permission for Villa Porto Rapallo and its associated partners, including event hosts and retreat collaborators, to capture and use photographs and video in which I may appear for promotional and marketing purposes. This includes, but is not limited to, use on websites, social media channels, email newsletters, press publications, and paid advertising by Villa Porto Rapallo and its affiliated hosts (including Lisa Pelloso and other featured experts). I understand that content may be shared across the platforms of these parties and used in both digital and print materials. I waive any rights to inspect or approve final content and understand that I will not receive any financial compensation for the use of this media.

Yes

No

General Marketing Communications

I would like to receive marketing updates, newsletters, and exclusive offers from Villa Porto Rapallo by email.

Yes