In the Moment June Retreat Shared Room Registration (ONE SPOT)

This is retreat registration for ONE PERSON in a shared, two person room.

You can share a room with a friend or be paired with a random woman on the retreat.

***If coming with a friend, please have your roommate register for their spot at the same time as you to ensure you secure your places. If wanting to be paired with someone, please write that in the form below.

A shared room (with two double beds or one king bed - depending on what beds are still available) is provided (at no extra cost) by In the Moment.

Contact information

Your name

Your first name

Your last name

Your email address

Your business name

Phone no.

Billing address

State/region

Your street address

Your city

ZIP

State/region

ZIP

Coming with a friend or wanting to be paired?

Name of friend if coming with a friend

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Contact information

Billing address

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In the Moment June Retreat Shared Room Registration (ONE SPOT)$0