Summer Retreat 2021 Registration
Conception Bay Renewal Centre
Name
Phone number (cell if possible)
Email address
Note: The first sitting begins at 8 am, and the last sitting ends at 8 pm.
½-day includes the morning practice, tea break, and lunch /
Afternoon practice starts at 1:30 pm, tea break, talk, supper, and practice until close.
Staying which days?
Staying overnight?
Approximate time of arrival
Dietary requirements
Emergency contact (Name and phone number)
Payment Details
$80/day incl. overnight
$60/day without overnight
$525 total for entire retreat incl. overnight
Other arrangements: (Please specify)
Payment Amount
Method of payment - due by July 3
Clear selection
Thank you!
The information on this form will be kept confidential by Safer Mindfulness, and will not be shared with a third party.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy