StoneSong 2025 Retreat Registration

Last Name*

First Name*

email*

Home address*

City*

U.S. State/Canadian Province*

Zip Code/Postal Code*

Country

United StatesCanada

Telephone number

Emergency Contact*

Emergency Contact phone number*

Emergency Contact email*

Lodging choice (price includes lodging, meals, and fee for retreat expenses)*

Camping ($764.00 total)Barn ($864.00 total)Farmhouse ($984.00 total)

Payment type*

$50 non-refundable deposit. Balance due June 1Partial payment. Balance due June 1Full payment

Dietary restrictions/considerations*

PLEASE CHECK ALL OF THE FOLLOWING BOXES *

I certify that I am at least 18 years of age and I identify as maleI understand that the activities of Jonathan's Circle retreats are for the purpose of exploring the connection between spiritual life and sexual practice and therefore will involve body experiences that may include, but are not limited to, touch, movement, deep breathing, dance, drumming, chant, song, poetry, ritual, the use of sacred texts, massage, meditation, silence, and yogaI accept responsibility for disclosing any condition I have that may be contagious to others in the group, acknowledging that retreat participants will be in close proximity to each otherI understand that the retreat will be drug and alcohol-free

Please furnish information on any medical, physical, or psychological conditions that may preclude participation in retreat activities (if this applies to you), i.e. allergies, sensitivities to food or other substances, etc.

Name one hope or expectation you have of the retreat.

Past retreats have featured workshops conducted by participants that have been valuable pieces of the StoneSong experience. If you would like to conduct a workshop, please describe it below.

Each year, we ask for donations that would allow us to give a scholarship for someone to attend StoneSong who may need assistance. If you wish to donate to the scholarship fund or to Jonathan's Circle in general, please state the amount you wish to contribute and for what purpose.

Waiver and Release Form (please check all boxes)*

I accept and voluntarily incur any and all risks of injury, damage, or harm to me which might arise from any activities or services provided by Jonathan's Circle, Inc., or its leaders, except only to the extent caused by gross negligence or other fault of Jonathan's Circle, its board, it's leaders, and other members or representatives of the organization.I acknowledge that this event is organized and led by private individuals and volunteers, and therefore I release and forever discharge all claims against Jonathan's Circle, Inc., its board, its leaders, and other members or representatives of the organization for any damages, injuries, losses or claims, whether known or unknown, that arise during or resulting from any activity or services provided by Jonathan's Circle or StoneSong Awareness and Nature Center.I further agree to indemnify and hold harmless Jonathan's Circle, their staff members and associates, as well as StoneSong Awareness and Nature Center and its management and staff from all losses, liabilities, damages, costs, or expenses except only to the extent caused by the gross negligence or other fault of any persons associated with Jonathan's Circle or StoneSong Awareness and Nature Center.