Ireland SAT Weekend

Registration Summary

Ticket type	Price	Fee	Ticket	Total
Registration Fee, Lodging and meals. Price : $250 Fee : $0 Ticket : 1 Total : $250.00				Registration Fee, Lodging and meals.	$250	$0	1	$250.00

Email address *

First name *

Last name *

Do you have any mobility or physical limitations or injuries which would be helpful for us to be aware of?

Do you take medications regularly? If so which ones?

Are you currently in therapy? If so, please state the nature and type of therapy.

How will you arrive at the retreat?*

If you are flying in, please give your flight arrival information. (day, time, flight number and airline)

Emergency contact name and number*

Do You have any dietary requirements or restrictions? Please not that New Dharma will make very effort but not all food needs can be accommodated.*

Gluten free

Allergy to nuts

Vegan

Vegetarian

Omnivore

Dairy Free

Mobile Phone

Billing Address