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Heart-Based Mindfulness

with Kate Mitcheom - CNM, MSN, RYT, EMP

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Register for January 2020 Mexico Retreat

You may register for the Retreat now with a $500.00 deposit. The balance of your Retreat Package is due on November 1st, 2019.

When you register, you will have a chance to indicate what type of room/accommodation you prefer. View Xinalani Website for more on accommodations

Register now to have your best shot at getting your first preference!

Name *

First

Last

Email *

Email

Confirm Email

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone number *

How did you hear about this *

Email from Kate Mitcheom Heart-Based Mindfulness
Email from Ellen Saltonstall
Saw on Kate's website
Saw on Ellen's website
Friend told me
Other

Please explain. Thank you!

What drew you to this Retreat? (Check all that apply) *

Mindfulness
Combo of vacation + learn mindfulness
Yoga
Warm weather Retreat
Rest and Relaxation
Ecolodge
Mexico location
Friends are attending
Other

Please explain. Thank you!

I plan to pay my $500.00 deposit by *

$500 by check (checks are preferred)
$500 by credit card

NO REFUNDS WILL BE MADE.

Your deposit of $500 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 $500.00 check to Kate Mitcheom and mail to:

Kate Mitcheom

17 Haycock Point Road

East Branford, CT 06405

Pay your deposit of $500 by credit card *

Price: $ 500.00

You 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.

My first choice for accommodation is: *

Deluxe room with one double bed: $2645 single occupancy
Deluxe room with two beds: $2095 pp double occupancy
Eco-chic suite with two double beds: $2565pp double occupancy
Eco-chic suite with one double bed: $2995 single occupancy
No preference - happy to be assigned a room

Open accommodations page in new tab to visit the Xinalani website and view rooms.

For housing purposes, do you identify as

Male
Female

The balance of your Retreat Package is due on November 1, 2019 *

I understand the balance of my Retreat Package is due on November 1, 2019.

Payments are non-refundable. We recommend you consider buying travel protection insurance. Learn more

Use this space if you wish to add an comments or questions

Email

Heart-Based Mindfulness

· 203-887-8932

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