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NeuroAwakening Thanksgiving Retreat Registration 2017
Neurofeedback Enhanced Meditation, November 24-26, 2017. Please complete one form per person.
Email completed form to TheScottJordan@gmail.com
Email address
Echo Rock Neurotherapy Retreat at St Francis Center
First Name
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Last Name:
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Street Address
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City
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State/Province
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Postal Code
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Country
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Cell phone
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Have you experienced neurofeedback at EchoRock Neurotherapy?
check the statement that best applies
Required
Are you currently being treated by a physician?
Are you mobility-impaired and rely on support?
Check if applicable
How often do you practice a specific style of meditation?
Choose the answer that best describes your experience
How long have you been practicing meditation if any ?
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Briefly describe your meditation experience.
Your answer
Do you have special dietary or medical needs?
A retreat manager will follow up to review your special needs.
Your answer
Room Selections
Single men and women are quartered separately. Cabins available for partners in relationship
Menu Selection
How will you get there?
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Questions?
Contact Jordan at TheScottJordan@gmail.com and enter your comments below.
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Will you pay with Check, Credit Card or PayPal?
Make your payment using the on the Website payment button
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