Sedona Retreat 2019 Registration Form
May 29 - June 2, 2019
Full name *
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Email *
Your answer
City/State or Province/Country *
Your answer
Cell phone number *
Your answer
Age *
Your answer
Emergency Contact Info (name/number/relationship) *
Your answer
I would like to share a room at Poco Diablo (not guaranteed that we will find you a roommate) *
Required
Medical concerns we'd need to know about (if any)
Your answer
Mobility limitations (if any)
Your answer
Dietary concerns (if any)
Your answer
My goals (big or small) in attending this retreat *
Your answer
Thanks for registering! To ensure your spot, please complete your payment of the deposit. Then, to make sure you get the reduced hotel rate, reserve your room at the Poco Diablo Hotel. See you soon in Sedona!
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