Registration for St. John Retreat 2018 Please enable JavaScript in your browser to complete this form.First Name *Last Name *Email *EmailConfirm EmailPhone *Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeHow did you hear about this Retreat? *What drew you to this Retreat? (check all that apply) *YogaMIndfulnessCarribean LocationRest and RelaxationEcolodgeCombo of Vacation + Learn MindfulnessOtherIf Other, please explain. If you were referred by someone who is also registering, please tell us. Your friend will receive a special gift upon arrival. And if you in turn refer someone, you will get a special gift upon arrival. Referred by The cost of the RETREAT is $2094. Non-refundable deposit due now: $698.00 2nd payment of $698 due September 1, 2017. Final payment of $698 due November 1, 2017. All payments are non-refundable. We strongly encourage checks, and we are ok with credit cards. I plan to pay by: *CheckCredit CardTravel Protection – You might consider purchasing a travel protection plan to help protect you and your travel investment against the unexpected. Travel protection plans include coverage for Trip Cancellation, Trip Interruption, Emergency Medical and Emergency Evacuation/Repatriation, Trip Delay, Baggage Delay and more. If you google travel insurance there are many companies from which to choose.Yes, I would like to receive the Heart-Based Mindfulness occasional newsletterNameSubmit