Common Ground Retreat at Prairie Farm Work Retreat Registration
This registration form is for those attending a work retreat organized by a Prairie Farm group leader. Prior to registering, please read the Practice Guidelines and review the additional information found on the Retreats at Prairie Farm webpage: http://goo.gl/E5KMr7.

Submitting a registration should be considered a firm commitment. Space is limited and scheduling can become complex. Last-minute cancellations might prevent others from staying at the property.

Use of the retreat property is offered on a donation basis. Given the circumstances in your life, please offer what you can to support the continuation of the retreat property.

Questions? Please contact prairiefarm@commongroundmeditation.org

Contact Information
Name *
Your answer
Email Address *
The registrar may need to share your email address with other retreatants.
Your answer
Phone number *
Your answer
Street Address, City, State, Zip *
Your answer
Arrival and Departure Dates
Please indicate how many nights you would like to stay, first and second choices for arrival and departure dates, and estimated times of arrival and departure.
Number of nights you would like to stay *
Your answer
First choice of arrival date *
MM
/
DD
/
YYYY
First choice of departure date *
MM
/
DD
/
YYYY
Second choice of arrival date (optional)
MM
/
DD
/
YYYY
Second choice of departure date (optional)
MM
/
DD
/
YYYY
Estimated time of arrival
Time
:
Estimated time of departure
Time
:
Have you ever stayed at the retreat property before? *
If yes, please indicate the approximate date and duration of stays.
Please indicate number of days or weeks as well as month and year of each stay.
Your answer
Please indicate your town or neighborhood:
Your answer
Practice Guidelines
Have you read and are you comfortable following the Practice Guidelines for the Retreat Property? *
There is a link to the Practice Guidelines in the introduction to this form.
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