Registration - Step 1

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Program Information

You are registering for:

Program:: Online: Re-discovering Joy with Yoga and Qigong
Dates:: June 18-19
Presenter:: Amelia Barili

Those enrolled in the retreat will receive the links for each one of the sessions of the retreat on Friday June 17 at 2pm.

Registrant Information

* First Name:
* Last Name:
Alternate Name:

* Gender:

Female
Male
Non-Binary

* Street Line 1:
Street Line 2:
* City:
* State/Province:
* Zip/Postal Code:
Country: Defaults to USA
* Telephone:
* Email:
* Email Again: Repeated to be sure it is right

Donation

Your generous donation will help support the presenter of these teachings and 10% will be donated to Sri Ram Ashram, an orphanage in Northern India founded by Baba Hari Dass

$50
$100
$300
Other:

Preferences

How did you first hear about this program?

HFS Email/Newsletter
MMC Program Brochure
Flyer or Postcard
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Shall we keep you informed of events at Mount Madonna Center?

Yes, send me occasional e-mail announcements.
Yes, send me postcards and brochures in the mail.
You may share my address with MMC affiliates.

Would you like to contribute to our Green Fund?
Amount

Green Funds will be used for sustainable innovations and eco-events at MMC.

Additional Requests

Important Notes

For cancellations up to Friday, June 17th at 11am you will receive a full refund. No refunds will be made after that time.

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