Register for "Awakening to Interconnection"


Thank you for registering for this retreat!

Please provide the following information to aid in our planning for the weekend.

Name *
Phone *
Address *
Please let us know about any specifications to your diet. If none, please write "none."
This is not intended to be a strenuous retreat, and any hiking or yoga is optional. However, a certain amount of walking is needed for some of our planned activities. Please let us know about any mobility specifications so that we can try to accommodate your needs. If none, please write "none."
Is there anything else that we should know about regarding your needs? Any background information about you which would be helpful? If none, please write "none."
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?
Would you like to receive our monthly newsletter? *