Victoria Meditation Retreat

...

* These fields are required

1 Welcome

Guest 1		First Name* Last Name* Email* Gender
Guest 1		First Name* Last Name* Email* Gender

Courtesy Titles
Suffix
Phone *
Mobile
Address
Address 2
City
State/Prov.
Zip/Postal
Country
Emergency Contact Info	Please provide a name and phone number
Dietary *	Please choose the dietary option above that applies to you. Please select Omnivore if you have no restrictions.
Do you require wheelchair accessible accommodations?	This could include other mobility aids (i.e. walker, shower chair).
Do you need ground floor accommodation? *
Program Comments or Special Needs	Please describe any special needs you have such as: Certified support animal(s), mobility needs, CPAP machine hookup, etc.
Birth Date
Age	25 & under 26-35 36-55 56-75 76+
Gender	We ask for gender to support respectful room assignments, inclusivity, and comfort for all guests in our ally-centred environment.
How did you hear about us?
Cancellation Policy *	I accept the terms and conditions.Please read the terms and conditions
Email newsletter	Please send me the email newsletter

CAD $	Support Bethlehem today Bethlehem is a charitable organization that relies on the generosity of donors like you to continue to welcome individuals exploring spirituality and seeking a non-judgmental sacred place for contemplation, learning, and community.

Discount code

Sub Total	$0

Donations	$0

Taxes	$0

25% Deposit	$0

Pay	Choose to pay a deposit or the full amount right now.

Due Now	$0 $0

Choose Payment Option

	Your registration will be complete once we receive your payment. Click on the button below and these instructions will be repeated on the next page.

	You will be asked for payment details in the next step. Click the button below to continue.