Growing Sacred Community, New Lebanon, NY, Sept 27-29, 2019
Registration Information
Email address *
First name *
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Last Name *
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Gender *
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Street address *
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City *
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State/Province *
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Zip Code *
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Emergency Contact - name, phone number, relationship to you *
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Mobile Phone (so we can reach you at the retreat if needed) *
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Do you have any special physical or mobility needs that would be helpful for us to know?
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Do you have specific dietary needs ? *
Would you like to share a space at the Shaman's market? (describe briefly your products)
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Do you need help finding people with whom to carpool to/from the retreat center?
Would you be willing and able to drive others for carpooling? *
Which lodging choice did you select?
If you have selected Dormitory or Double room, please type the name(s) of the person(s) you would prefer to share the room with :
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