Costa Rica 2018 Registration View full details of this Retreat REGISTER HERE FOR THE COSTAN RICA REJUVENATION RETREAT, January 2018 Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *EmailConfirm EmailAddress *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone number *How did you hear about this *Email from Kate Mitcheom Heart-Based MindfulnessEmail from Ellen SaltonstallSaw on Kate's websiteSaw on Ellen's websiteFriend told meOtherPlease explain. Thank you!What drew you to this Retreat? (Check all that apply) *MindfulnessCombo of vacation + learn mindfulnessYogaWarm weather RetreatRest and RelaxationEcolodgeCosta Rica locationFriends are attendingOtherPlease explain. Thank you!I plan to pay by *$2095 by check (checks are preferred)$2095 by credit cardNo refunds will be made. Your payment of $2095 is due immediately following registration. *I understand that my space is not reserved until Kate Mitcheom receives my check at the address listed below.Please make out your $2095.00 check to Kate Mitcheom and mail to: Kate Mitcheom 17 Haycock Point Road East Branford, CT 06405 Pay your deposit of $1045 by credit card *Price: $ 2,095.00You will be sent to Paypal to complete your purchase. You may choose "Pay with debit or credit card" and check out as Guest, if you wish. No need to have a PayPal account. EmailSubmit