Name *

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Phone *

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Address *

Address 1

Address 2

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Select registration type *

Notes: Earlybird Single room: $1450 Earlybird Double Room: $1325 All accommodation types have a shared bathroom Prices include full program: accommodation, food, program content, and materials

Single room

Double room

Can we use photos of you in future promotional materials? *

We'll be taking some photos at the retreat and we'd love to use them when promoting upcoming events. Is that ok with you?

Yes

No

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