You are registering for:
Summer Solstice / Four Elements Women’s Retreat
June 21-23, 2024

Step 1 - Fill Out Registration Form

Name

First Name

Last Name

Phone

(###)

###

####

Email Address

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Do you have any dietary restrictions?

None

Vegetarian

Vegan

Gluten Free

Dairy Free

Lactose Free

Soy Free

Additional dietary notes

Emergency Contact

First Name

Last Name

Emergency Contact Phone

(###)

###

####

What will be your method of payment?

If you will not be paying online, please list your top two room preferences. See below for current available options.

If booking a double occupancy room (shared bed), one person must book and pay for the room. Please list the name of the other occupant/attendee below. Please note: BOTH attendees must complete and submit this registration form.

First Name

Last Name

How did you learn about this retreat?

Facebook post, Cindy's newsletter, Friend, etc.

What were the primary factors that helped you decide to attend?

Be sure to CLICK 'SUBMIT' BUTTON above before proceeding to payment.

Your registration will be pending until payment is received.

Please Note:

Registration for this retreat is limited. You must complete the above registration form AND payment to reserve your spot.
Each individual participant must complete and submit the above registration form.
Payment must be received before registration is complete.
To pay online, follow steps 2 & 3 below.
To pay via check, please send to: Cindy Novelo, 842 E. 12th St., Lawrence, KS 66044
If you are a regular client, you may bring payment to your next in-person class or session.

Step 2 - Select Your Room

Please Note: If you are booking a shared room (double occupancy) one person will need to book and complete payment for the room. Please complete the registration form above for each participant.

If you have mobility restrictions, please choose a room in the main lodge.