Retreat Registration Form (October 2018)
This is a non-residential retreat. Additional information about the retreat, including its exact location and what to bring, will be provided to all participants who are selected to attend.

A lottery will be used to select retreatants. The lottery will occur 2 weeks prior to the retreat. Those not selected can be placed on the Waiting List. If an applicant is not selected in the lottery after applying for a retreat, the probability of getting accepted increases with each subsequent retreat they apply for.

Name: *
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Email: *
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Phone: *
example: 123-456-7890
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City: *
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Age: *
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Emergency Contact Name: *
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Emergency Contact Number *
example: 123-456-7890
Your answer
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This form was created inside of Flagstaff Insight Meditation Community.