Mindful Mosaic® Women's Retreat - Old Saybrook, CT - June 20

MINDFUL MOSAIC® WOMEN'S RETREAT

JUNE 20 - 24, 2019

OLD SAYBROOK, CONNECTICUT

Please fill in the form below to request your reservation.

Full Name*

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Address

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How did you hear about the Mindful Mosaic Women's Retreat?*

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Dietary needs: Meals will be both Gluten-free and Soy-free. Each meal will include a Vegan option.If you have any other dietary needs for health reasons, please explain here.

Please indicate any physical disabilities or special needs we will assist in making your stay as comfortable as possible

Are you experiencing some sort of transition in your life? If so, use 3 words to describe how this feels.

Please list your goals, dreams, aspirations. No limits.

How do you plan to travel to the retreat location?

Are you planning to attend with a group? If so, please let us know how many members will attend and any other information that will help us to better assist you including group members' names and contact info. Group deals may be available.

Enter roomate(s) name(s)

Roomate Phone Number

Area CodePhone Number

Roomate E-mail

NOTE: If you are interrested in more information or would like to pay by phone complete this form and one of our representatives will contact you within 24 hrs. Payment plans may also be arranged by phone.

Call (212)245-3129

Please note that due to the unique architectural quality of the property rooms all vary slightly in size, décor, view.

Please select your room:

SAILOR SUITE - Double - Shared Bath with Seagull Suite$2,263.00

WELLNESS EXPERIENCE UPGRADE

SAILOR SUITE (3 Month Payment Plan) - Double - Shared Bath with Seagull Suite $754.33

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LIGHTHOUSE SUITE - Single - Private Bath$2,499.00

WELLNESS EXPERIENCE UPGRADE

LIGHTHOUSE SUITE (3 Month Payment Plan) - Single - Private Bath$833.00

WELLNESS EXPERIENCE UPGRADE

THE SUNRISE SUNSET SUITE - Double (Shared Occupancy) - 2 Twin Beds Shared Bath w/ Staff$1,999.00

WELLNESS EXPERIENCE UPGRADE

THE SUNRISE SUNSET SUITE (3 Month Payment Plan) - Double (Shared Occupancy) - 2 Twin Beds Shared Bath w/ Staff$686.00

WELLNESS EXPERIENCE UPGRADE

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Total $0.00

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Please note:By using the Mindful Health Services and registering for this event, you acknowledge that you have read, understood, and agree to be legally bound by the terms and conditions of these Terms of Use and the terms and conditions of our Privacy Policy, which is hereby incorporated by reference (collectively, this "Agreement."). If you do not agree to any of these terms, then please do not use the Services.

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b. Certain of the Services may be subject to additional terms and conditions specified by us from time to time; your use of such Services is subject to those additional terms and conditions, which are incorporated into these Terms of Use by this reference.

c. ARBITRATION NOTICE AND CLASS ACTION WAIVER: EXCEPT FOR CERTAIN TYPES OF DISPUTES DESCRIBED IN THE ARBITRATION SECTION BELOW, YOU AGREE THAT DISPUTES BETWEEN YOU AND US WILL BE RESOLVED BY BINDING, INDIVIDUAL ARBITRATION AND YOU WAIVE YOUR RIGHT TO PARTICIPATE IN A CLASS ACTION LAWSUIT OR CLASS-WIDE ARBITRATION.

You are responsible for notifying Mindful Health of any food allergies or other allergies related to normal food preparation prior to the retreat. By signing this form you agree that Mindful Health, it's representatives, agents, contractors or any corporation, landowner, property, partner or property where the retreats are held shall not be liable or responsible for any food, beverages, or any other products or services offered or provided by the chefs,restaurants, servers or retreat facilitators or any food-borne illness, discomfort, pain,harm or injury incurred by you the user, participant or client.

Please see additional terms and conditions upon hovering over the signature box above.

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