S-Anon

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1 Welcome

2 Price

3 People in your group

4 Optional Items

5 Participant Info

Phone	Please provide your primary phone number where we can best reach you regarding your registration or retreat details.
Address	Please provide your mailing address. This is helpful for registration records and for mailing donation receipts or printed copies of retreat information when needed.
Address 2
City
State/Prov.
Zip/Postal
Country
Emergency Contact Info	Please provide the name and phone number of a person we can contact in case of an emergency during your stay. This should be someone not attending the retreat with you, if possible.
Dietary	Please choose the dietary option above that applies to you. Please note that the options listed in the dropdown reflect the dietary needs our kitchen is able to accommodate. Please select Omnivore if you have no dietary restrictions.
Do you have any severe food allergies?	No Yes Please select “Yes” if you have a food allergy that may trigger serious reactions (e.g. anaphylaxis, hives, swelling, etc.). If you do have severe allergies, we encourage you to bring any necessary foods or supplements you may need, as we cannot guarantee complete avoidance of all allergens in our kitchen environment. If you have any questions or would like to discuss your meal needs during your stay, please connect with Guest Services before or upon arrival.
If yes, please specify	Please specify your severe food allergies. If you have very particular dietary needs we suggest you bring supplementary food to support your experience. Feel free to contact guest services to discuss: guestservices@bethlehemcentre.com
Do you need ground floor accommodation?	Please let us know if you require ground floor lodging for accessibility. We have a small number of ground floor rooms in the Main House, with the remaining accommodations located in external buildings. This helps us support your stay, as availability may be limited depending on the retreat.
Do you require wheelchair accessible accommodations?	This could include other mobility aids (i.e. walker, shower chair).
Birth Date
Gender	We ask for gender to support respectful room assignments, inclusivity, and comfort for all guests in our ally-centred environment.
Program Comments or Special Needs	Please share any additional information that will help us support your stay, such as specific program requirements, electric vehicle charging needs, CPAP machine use, certified support animal(s), or any other details we should be aware of.
How did you hear about us?
Email newsletter	Please send me the email newsletter
Cancellation Policy	I accept the terms and conditions.Please read the terms and conditions

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7 Payment