| Registration Form |
AFTER REGISTERING ON THIS PAGE, YOU CAN CLICK
TO MAKE A PAYMENT
(please scroll to bottom of this page to view all of the form)
the Sufi in the World
A Sufi Movement In Canada Retreat
STEP 1 of 3, FILL OUT THIS REGISTRATION FORM
Street Address 1
Street Address 2
Home Phone Number
Mobile Phone Number
(what we use to contact you)
ROOM REQUEST ________________________________________________________
Please indicate the type of accommodation you would prefer.
If you are not choosing a single room, please enter the name of the person(s) who you would prefer to room with.
RETREAT & ROOM FEES ________________________________________________________
All prices are in Canadian dollars.
Final Payment due by May 1st
Single Occupancy (1 in a room)
full payment $970.00
Other Occupancy (2 or 3 in a room)
full payment $800.00
Do you reqire a handicapped accessible room?
Yes I do
HOW WILL YOU MAKE YOUR PAYMENT? ________________________________________________________
Please choose a method of payment:
PayPal (service charge applies)
DIET INFORMATION ________________________________________________________
Please indicate dietary preferences:
Food preferences must be finalized by June 10, 2018.
Are you interested in a canoe rental?
Yes I am.
MEDICAL AND ALLERGY INFORMATION ________________________________________________________
Do you have any medical condition that we should be aware of?
What should be done in case of an emergency?
Who should be contacted in an emergency?
What phone number should be used to contact this person in an emergency?
Please list any food allergies so we can discuss them with you and the lodge
How do you plan to travel to the retreat?
STEP 2 of 3, CLICK HERE TO MAKE A PAYMENT
this will clear all fields