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Registration Form

Ekodo Retreat & Workshop 23-27 April 2020, Shambhala, Golden Bay.

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Name *

First

Last

Email *

Phone Number *

Address *

Line 1

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City

State

Zip Code

Country

Select Option *

Adult Waged ($360) Adult Unwaged ($285) Secondary School Student ($180) Non-residential ($45/day)

Special dietary requirements (if any) *

Other requirements (if any) *

Transport requirements (if any) *

Bringing children? If so, please state age/s and how many *

I am a school student and here is my age, and my parent's/guardian's name email and phone number *

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