Kindness and Wisdom Meditation Retreat 2017 Registration
Complete one form per person and click the SUBMIT button at the bottom of the page.
Sign in to Google to save your progress. Learn more
First Name *
Last Name *
Email *
Address *
City *
State/Province *
Postal Code *
Country
Best phone to reach you *
Gender *
Required
Age *
How long have you been practicing meditation? *
Choose the answer that best describes it
Do you practice meditation using the Six Rs? *
Required
Briefly describe your meditation experience. *
How will you get there? *
Required
The menu is buffet style vegetarian. Do you have special dietary or medical needs? *
The retreat manager will follow up to review your special needs.
Single Occupancy Rooms $850 ($250 minimum deposit required)
Method of payment
Double Occupancy Rooms $650 ($250 minimum deposit required)
Method of payment
Do you wish to be put on a wait listed if the retreat is fully booked when registering.
Note: you must register and pay the minimum deposit to be on the wait list.
What menu option do you prefer? *
Choose the menu option that you will maint throughout the retreat
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms