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REgistration for Silent Contact Retreat
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What is your name? *
What is your email address? *
What is your phone number? *
Please share why you want to participate in this silent retreat.  *
Please share your experience with Contact Improvisation. *
Please share your experience with Authentic Movement.  *
Please share your experience with Contemplative Dance Practice.  *
Please share your experience with meditation. *
Do you feel internally resourced to participate in a several day silent retreat? Please share any hesitations or concerns you might have. *
Is there anything we should know about your mental health such as medications, conditions or if you are under the care of a mental health practitioner (psychiatrist, therapist etc..)?
*
Is there anything we should know in the event of an emergency (serious allergies, conditions, medications etc.)?
*
Please share an emergency contact person and their phone number.  *
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