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Gathering Registration

Please fill out and submit the form below to register your participation in this gathering. PLEASE REGISTER WITH YOUR FULL NAME AS SHOWN IN YOUR PASSPORT 

Costa Rica Gathering 2022 Registration

Personal Details

Full Name

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Email

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Address

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State/Suburb

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City

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Zip Code/Post code

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Country

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Home Phone Number (+area code)

Mobile Phone Number (+area code)

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Date of Birth

Emergency Contacts

Emergency Contact Name

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Emergency Contact Number (+area code)

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Dates

Flight arrival details

Arrival Date

Departure date

Extra Information

Special Needs/Dietary: (Vegan, vegetarian, pescatarian, no dairy, no gluten, no beef, etc.

I wish to room with:

Which retreat attending? [First/Second/both]

Extra information/notes

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