Program Information

* marks required fields

You are registering for:

Yoga, Service and Community Forum & Retreat
October 27-29

The prices below are the Total charges for lodging, meals, and use of facilities.

Registrant Information

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

How does my choice affect my housing?
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


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


Dietary Restrictions

Additional Requests

Include the following in your additional requests:

Important Notes