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 that the dates & time below are what you intend to register for, and then click on submit:
	Italian Mindfulness Retreat - May 26th - June 3rd, 2009

Upon completion and submission of this retreat registration form, you will be sent a confirmation which will include recommeded flight information. Please call 713.522.7032 or email us if you do not receive this email notification.

You may reserve your spot by making a NON-REFUNDABLE $600 deposit. To remit your deposit, please click here.