Mindful Living

Italian Retreat Registration

Name:
Address:
Address 2:
City:
State/Province:
Zip/Postal Code:
Phone- Work:
Phone- Home:
Phone- Cell:
Email:
Re- Enter Email:
How did you find out about the Italian Retreat?

What brings you to the retreat? In other words, why are you considering it?

Please provide a brief description of your experience with mindfulness meditation. For example, are you a beginner, have you practiced another kind of meditation, have you had formal mindfulness training?

Please confirm which retreat you intend to register for and then click on submit:
	Italian Mindfulness Retreat #1 - May 25-29th, 2010 - CLOSED
	Italian Mindfulness Retreat #2 - June 1-5th, 2010

Once you have submitted this form we will send you a formal confirmation, via email. Please allow 3-4 business days, as we process these registrations manually. Feel free to call 713.522.7032 or email us if with any questions or comments.

To insure your reservation at the retreat you need to submit your NON-REFUNDABLE $800 deposit.

Click here to pay your deposit. Thanks!