To register for workshops, activities and/or gatherings, please fill up form below, print and send in with the required deposit or full workshop payment(s) to confirm attendance. Make check payable to: Rockhaven Ecozoic Center.

Date:

Name:
Email Address:
Street Address:
City: State: Zip:
Phone: Phone (secondary contact number):

Indicate program, workshop or activity/gathering for which you are registering.

Date:

Date:

Date:

Date:

Payment:
Deposit (confirms your registration)
Full workshop payment
Accommodation fee

Total payment enclosed


Donation for scholarship fund:

-Scholarship donations are tax deductable. Contact Rockhaven for more information.
-All deposits are non-refundable. Full refunds will be issued if the workshop is cancelled due to low registration or inclement weather.


Accommodation:
Commuter Residential Lunch only


Meals:
Please check all that apply vegetarian vegan eat fish eat poultry eat red meat (Rockhaven serves healthy balanced meals. If you have allergies or medical dietary requirements, please let us know in advance. Those with dietary preferences are welcome to bring their own food if desired.)


Travel (out of state travellers):
I plan to arrive on (date/time) by: car train plane (If requesting Rockhaven transportation, please confirm with the office before making travel reservations.)