Friday, October 26th, 9 am – 5 pm

2816 Pleasant Union Church Rd. Raleigh NC 27614

Registration is now open. Thank you for signing up!

Sliding Scale Fee $40-$70

(Please consider paying the maximum fee so that others who have need can be supported.)

You may either complete the form below or open the attached file and send it to us.

Download application form

You can make your payment through PayPal (in our "Donate" button) or by mailing us a check. (Please note that if you choose to use PayPal the minimum payment is $65 in order to accommodate PayPal's service fee.) 

Name *

Name

First Name

Last Name

Age *

Address *

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Telephone: *

Telephone:

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Email Address *

Dietary Restriction/Allergies *

Please describe any physical limitation that you would like us to be aware of. Is there anything you would like to experience most from this retreat? *

Let us know your meditation experience. *

Thank you! Your reservation will be confirmed automatically once we have received your payment.