Program Information

* marks required fields

You are registering for:

Program:
Healing the Healers
Dates:
July 14-16
Presenter:
Melissa Lucey

The prices below are the Total charges for lodging, meals, and use of facilities.
A tuition charge of $200 will be added.

Spouses, significant others, and families are welcome! To register a spouse/partner and/or children, in the box "Additional Requests" near the bottom of this page, please include the full names of spouse/partner and any other family members, as well as the ages of any children accompanying you. If you need an early arrival or late departure, or are coming with a party larger than three and require more than one room, please specify in that section as well. We will manually register additional party members and you will receive a confirmation email with an added balance due that accurately reflects these additions.

IMPORTANT: Please do NOT fill out the "sharing with" field nor do you need to register the other members of your party separately.


When you choose your accommodations, please select as your first choice the option that best suits accommodating your full party (e.g. if coming with just your spouse/partner select one of the Double occupancy options, if also coming with a child or any party of three select the Triple option).

Registrant Information

* First Name:
* Last Name:
Alternate Name: Defaults to First
* Gender Identity:




How does my choice affect my housing?
Pronouns:
Why pronouns matter
* Street 1:
Street 2:
* City:
* State/Province:
* Zip/Postal Code:
Country: Defaults to USA
* Telephone:
* Email:
* Email Again: Repeated to be sure it is right
Car License: If you are driving to MMC.

Housing Choice

If you are sharing your housing with someone, put their name here:

If given a choice, would you prefer a cabin or a room?

Gift Card

Preferences

Carpooling   Privacy Concerns?

How did you first hear about this program?

Shall we keep you informed of events at Mount Madonna Center?

Massage and other Bodywork

Donation

Dietary Restrictions

Additional Requests

Include the following in your additional requests:

Important Notes