Cell Phone:_____________________Home phone:______________________
Emergency Contact name & phone: ____________________________________
How did you hear about Seeking Stillness________________________________
What would you like to see happen over the course of the retreat? ______________
Massage? ______1/2 hour ($42) _____1 hour ($61)
(Massage prices are payable directly to the massage therapist at The Pines and
do not include gratuity)
Please list any special dietary needs or food allergies________________________
Please make check payable to: Seeking Stillness Ministries.
Mail check and completed registration form to:
Deb Griest 626 Revere Dr. , Bay Village, OH 44140
firstname.lastname@example.org | 440-871-8764
Cancellation Policy: no refunds will be given if cancellation is within 16 days of start date of retreat.
___ By checking here, you agree to share your contact information with other retreat attendees only. Your private information will never be shared or used for any purpose other than Seeking Stillness Ministries.
___ By checking here, you agree to allow any photos taken to be used in Seeking Stillness print or web materials.
___By checking here you have read and understand what we believe https://seekingstillness.org/beliefs/