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N O W H E R E 3-day retreat sign-up
REGISTRATION FORM
for a 3-day silent meditation and yoga retreat with Aaron Knowles Dias. Friday May 26 -
Monday May 29, 2023 at Pumpkin Hollow Retreat Center in Craryville, NY.
Once you have completed this form +
paid your deposit
, you are considered registered.
Aaron will personally email you to follow up within 1-5 business days.
* Indicates required question
Email
*
Your email
Name
*
Your answer
Are you registering for a SHARED room or PRIVATE room?
Shared Room (with 1 - 2 other guests)
Private Room
Clear selection
Any requests about roommates or accommodations?
Your answer
Everyone is a vegetarian while visiting Pumpkin Hollow.
And much of the food is grown from the garden or at least organic!
Dietary Restrictions
Dairy free
Gluten free
Other:
Clear selection
What would you most like to get out of this retreat?
Your answer
Do you have any physical injuries that should be considered during yoga, reiki, extended sitting, or getting around the retreat center?
Your answer
Emergency Contact Name
Who should we call in case of an emergency? Name + Relationship
Your answer
Emergency Contact Phone Number
Your answer
Anything else that you want to share or ask?
Consider what would be most helpful as I plan to accommodate your stay and facilitate your retreat experience.
Your answer
If you want to coordinate travel to / from retreat please use the Ride Share spreadsheet.
RIDE SHARE
Looking forward to being there with you soon! If you still need to make your payment, use the link below for instructions.
PAYMENT INFO
Send me a copy of my responses.
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