Canadian Couples' Retreat Registration
Registration for the first ever Canadian Couples' Retreat Sept 28-30 at Nirvana Retreat Centre in Ontario!
Partner 1 - Legal Name *
Your answer
Partner 1 - Initiated name, if applicable:
Your answer
Partner 1 - Phone number and email: *
Your answer
Partner 2 - Legal Name *
Your answer
Partner 2 - Initiated name, if applicable:
Your answer
Partner 2 - Phone number and email: *
Your answer
What city do you live in? *
Your answer
What kind of couple are you? *
Will you stay at the retreat centre? *
Do either of you have any dietary restrictions we should be aware of? *
Your answer
Emergency Contact Name and Phone Number *
Your answer
What would you like to get out of the retreat?
Your answer
Anything else we should know?
Your answer
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