Black Arts Retreat 2018 Registration
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BLACK ARTS RETREAT NORTHEAST 2018
Friday Nov 16 - Sunday Nov 18 2018

Our 6th Annual Retreat will be held at Murray Grove Retreat & Renewal Center in Southern New Jersey

BAR Northeast Features: Yoga * Hiking * Jam Sessions * On-Site Counseling * Meditation * Movement Building * Arts Market * Yummy Vegetarian Cuisine * Honoring Haiti * Participant Led Sessions!

Participant Led Sessions: For the first time, BAR Alum will be able to lead/ co-facilitate/ hold space for any workshop or topic of their choosing at Black Arts Retreat Northeast!

Black Arts Retreat Northeast 2018 Registration is now Pay What You Can! Registration is only offered to Black Arts Retreat Alumni and their guests. Only one new Retreater per Alumni please. First come, first served.

IMPORTANT! PLEASE NOTE:
In order to accommodate the Pay What You Can policy, we ask that all participants to contribute to the BAR Menu & Supplies for the weekend. Details will be confirmed closer to the retreat date. Our base cost per retreater is approximately $200, so if you can meet or exceed this cost, then please do! If not, give what feels good to you!

TO REGISTER
Complete this form and submit your donation to blackartsretreat@gmail.com via PayPal. Please write your FULL NAME or the name of the person you are donating for and "BAR Northeast" in the PayPal notes.

CHECK OUT
www.blackartsretrat.com & follow us on instagram ! @blackartsretreat #blackartsretreat

PLEASE NOTE
Participants are responsible for arranging their own transportation. If you can drive, please do and take others with you. We will support organizing a ride-share system. There is public transportation to the Lanoka Harbor Area via NJ Transit. Please indicate your transportation status in form below. Regarding Lodging, rooms are double occupancy; you can write preferences for lodging in the form below.

FEEL FREE TO EMAIL BLACKARTSRETREAT@GMAIL.COM with any questions.
Thank You! We look forward to seeing you soon!

Email address *
First Name *
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Last Name *
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Name you prefer to be called
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Address Line 1 *
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Address Line 2
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City, State, Zip Code *
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Best number to reach you *
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Please select your preferred set of pronouns *
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Emergency Contact Name 1 *
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Emergency Contact Relationship *
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Emergency Contact Number 1 *
Your answer
Have you previously attended Black Arts Retreat? *
List any food restrictions or allergies you may have *
Your answer
Do you have any additional allergies or sensitivities you want us to be aware of ? *
there will be open fire and essential oils used during this trip: list any smells/ sights etc that may bother you
Your answer
Do you have any emotional, psychological and/or physical challenges that could effect your participation during this trip? **Please note that health information will be kept confidential, and is gathered to both accommodate and protect participants** *
Activities include Hiking , Yoga, Fire Building, Dance, Rigorous Exercise etc. All activities are optional.
Your answer
Are you currently taking any medications (prescription or over the counter) ? *
If Yes, please list. Note that your responses are confidential.
Your answer
Do you experience from any of the following... *
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Do you have any of the following skills useful for outdoor activity? *
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Please check all that apply *
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This year's retreat will be held at a location with shared rooming arrangements. Do you have any preferences about with whom you share a room? *
If you would like to share a room with someone in particular, please indicate that here.
Your answer
If you have never attend a Black Arts Retreat, please state who invited you to this year's retreat:
Your answer
Would you like to be included in the BAR Northeast 2018 Participant Directory? *
Please list your passions and areas of interest
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Please list your areas of expertise, including but not limited your professional vocation(s)
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What would you like to gain from this retreat experience? *
Your answer
How will you be traveling to the retreat site? *
**NOTE: those desiring to carpool are asked to contribute to travel costs at Driver's discretion
If you are a Driver who is willing to accommodate others with carpooling needs, how many people can you take in your vehicle?
Are you a Driver who is willing to rent a car to assist with ride- shares?
Do you have any questions, comments, concerns or suggestions for the hosts of this Retreat?
Your answer
Terms and Agreements: I agree to respect and honor myself all the participants of this trip. I will not engage in any behaviors deemed uncomfortable or unsafe by the Black Arts Retreat community. I am aware that I am fully responsible for my own safety and am expected to contribute to the safety of other Retreat participants. I take full responsibility for my emotional, psychological and physical well-being throughout this Retreat Experience. I will follow the rules of the Murray Grove Center and honor the agreements of the Black Arts Retreat community. I understand that if I do not adhere to these agreements that I may be asked to leave immediately and forfeit any payments made towards the Black Arts Retreat Experience. I understand that I am responsible for any damages, personal harm, or injury incurred during the time of the Retreat. I recognize that organizers of the Black Arts Retreat and their affiliates are not responsible for any damages incurred. *
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