Women's Retreat Registration Form
Name
*
First Name
Last Name
Spiritual Name
optional
Date of Birth
*
-
Month
-
Day
Year
Date
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact Name
*
Emergency Contact Phone Number
*
Please enter a valid phone number.
Emergency Contact Email
example@example.com
Allergies / Dietary Restrictions
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What are you hoping to gain from this retreat?
Do you have any accessibility needs regarding accommodation? (i.e The use of staircases)
*
Please Select
Yes
No
Please give us some more information
Are you traveling with anyone and/or do you have a preference for a roommate? Please Include details to help us best match your needs with the available accommodations.
Would you be interested in providing a scholarship registration for a fellow retreat attendee? If 'Yes', our team will reach out with more information.
Please Select
Yes
No
Registration Options
*
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( X )
Standard
Cabin with dorm style bunk beds & communal bathrooms.
$
250.00
Quantity
1
Premium
Shared rooms with private bath; recommended for groups) Our accommodations team will reach out to discuss room options after registering. Please include details about your group.
$
310.00
Quantity
1
Private Room
Private Room - only 5 available
$
400.00
Quantity
1
Our refund policy offers varying options based on the cancellation date. Cancellations made on or before September 15th receive a full refund, minus a $10 fee. From September 15th to October 14th, a 50% refund, also minus the $10 fee, is available. However, cancellations after October 14th are not eligible for any refund.
*
I have reviewed the refund policy
Liability Release: I release ISKCON of DC, its staff, volunteers, sponsors, and others involved in the activity from any liability for costs, injuries, or other claims arising from participation in this retreat. I consent to medical treatment if necessary while engaged in this retreat. Additionally, I agree to allow ISKCON of DC to record my image during the activity for promotional purposes, and I waive any claims related to the use of these materials.
*
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Pay with PayPal
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please click one of the PayPal options to complete payment and
submit
the form.
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