Registration for Thimble Island House September 2017 Retreat Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.First Name *Last Name *Email *EmailConfirm EmailPhone *Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeWhat drew you to this Retreat? (check all that apply) *YogaMIndfulnessLocationRest and RelaxationOtherIf Other, please explain. How did you hear about this Retreat? *Earning a discount?I would like the $50 discount for bringing a friendName of my friend: The cost of the RETREAT is $550, all inclusive with a $50 discount if you bring a friend.. Full, non-refundable payment due with your registration. We strongly encourage checks, and we are ok with credit cards.I plan to pay by: *CheckCredit CardYou will receive instructions on how to pay by check or credit card in the confirmation email you will receive after hitting "Submit". ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~Yes, I would like to receive the Heart-Based Mindfulness occasional newsletter~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~CommentSubmit