Registration Form and Questionnaire March 2020 Residential Retreat
Registration for the February 1st retreat LOTTERY has ended. However, by completing the registration form now, your name will be placed on a waiting list in the order in which it is received. We will invite the first person on the waiting list if a space becomes available. Additional information about this residential retreat, including its exact location and what to bring, will be provided to all applicants invited to attend.

You will receive a copy of your completed questionnaire by email shortly after submitting this form – please enter your email address mindfully. To review or change the previous page, only use the BACK button at the BOTTOM of the page. Using the back button in your browser will result in loss of data that must be re-entered.

IMPORTANT:
IT IS A REQUIREMENT THAT ALL REGISTRANTS READ AND AGREE TO THE TEACHER'S PRACTICE GUIDELINES IN THE FINAL SECTION OF THIS QUESTIONNAIRE. PLEASE READ THEM CAREFULLY BEFORE SUBMITTING THIS FORM.

Email address *
First name *
Your answer
Last name
Your answer
Phone *
example: 123-456-7890
Your answer
City *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Number *
example: 123-456-7890
Your answer
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