Retreat Intake/Registration
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Email *
What is the name you wish to be called? *
phone number 
Where are you coming in from? *
Will you be driving or needing a ride? *
Do you have any heath concerns or Injuries we should know about? *
Do you have any dietary restrictions? 
Which retreat? *
How much personal growth or self development work have you done?  (It's ok if the answer is zero)
Who is an emergency contact person? Name/Relationship/phone number
Agreement by the registrant to the use and distribution of the registrant's image or voice in photographs and videos of such events and activities hosted by Shara Ogin.
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Liability Release: By signing below, I release Shara Ogin and assistants from all liability which may arise from any and or all claims by me or any third party in connection with my participation in the retreat.  Please type your name below.
Anything else you would like to share?
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