Meditation Retreat Welcome

Welcome to the 2021 Meditation Retreat!

Maria and I look forward to seeing you there from December 3-5.

Please fill out the Registration Form below to finalize your registration.

If you have any questions, please email me

Name*
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Enter Email Confirm Email
Phone*
Room Preference*
Room Mate Preference
To be completed if you choose to Share a Room
Preferred Roommate Name
Preferred Roommate Phone
Diet Considerations
- Gluten Free
- Vegetarian
- Vegan
- None
Please check your diet preference
Allergies
Please list any allergies you may have
A copy of your Covid Vaccination Certificate*
Max. file size: 1 GB.
Please upload a copy of your Vaccination Certificate here. You can scan the certificate and then load it from your computer, or take a photograph and load the image here