Matariki Enspiral Winter Retreat 2021
2 - 4 July 2021, Riverslea Retreat Centre, Otaki Gorge

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Your preferred first name *
Whatever nick name you prefer to be called
Your last name *
Dependent details
Name and age and needs of dependants that will come with you, under your responsibility
Your email *
Your physical address *
This is for the invoice
Your phone number *
This is for any urgent retreat co-ordination
Your details published? *
Indicate if your contact details (name, e-mail, phone number) can be shared amongst registered participants
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