Day of Mindfulness: Rest, Reflect, and Rejuvenate (January)

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1 Welcome

2 Price

Please choose the pricing level that best reflects your personal financial situation and comfort level. A price must be selected to register you for this retreat.

If you would like to add-on extra nights, you may do so below. However, to book additional meals for those days you must contact the Registrar, Christine Noelle, at cnoelle@sienaretreatcenter.org or (262) 898-2582.

Add extra nights - $90.00/night: nights before and nights after

Select a price.

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$85.00 – Partner Cost

Guests

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$115.00 – Advocate Cost

Guests

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$145.00 – Sustainer Cost

Guests

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3 People in your group

Guest 1		First Name* Legal name only Last Name* Email* Please select the option that broadly characterizes your diet.* There is a field below where you can share specific dietary needs, such as allergies & intolerances or variations such as pescatarian (eats fish but no other meat) or no pork/red meat. Please share any food allergies you may have. Please note that we make every effort to accommodate each person's dietary needs but highly specific diets may be outside of our ability to serve. We are not an allergy-safe kitchen.
Guest 1		First Name* Legal name only Last Name* Email* Please select the option that broadly characterizes your diet.* There is a field below where you can share specific dietary needs, such as allergies & intolerances or variations such as pescatarian (eats fish but no other meat) or no pork/red meat. Please share any food allergies you may have. Please note that we make every effort to accommodate each person's dietary needs but highly specific diets may be outside of our ability to serve. We are not an allergy-safe kitchen.

After completing this form, emails will be sent to everyone in your group to complete their information.

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4 Participant Info

Phone *
Address *
Address 2
City *
State/Prov. *
Zip/Postal *
Country *
Please select the option that broadly characterizes your diet. *	There is a field below where you can share specific dietary needs, such as allergies & intolerances or variations such as pescatarian (eats fish but no other meat) or no pork/red meat.
Please share any food allergies you may have.	Please note that we make every effort to accommodate each person's dietary needs but highly specific diets may be outside of our ability to serve. We are not an allergy-safe kitchen.
Special Needs (ADA / Accessibility)
Emergency Contact Name *	Please list the name for someone who we can contact in case of emergency during your time on retreat.
Emergency Contact Phone Number *
How did you hear about this retreat?
Would you like to receive the e-newsletter from Siena Retreat Center?	Yes! Please add me to the email list!

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5 Donate

$	Operational Donation Please select an amount if you would like to make an additional donation to support operational expenses for the retreat ministry.
$	Scholarship Fund Donation Please select an amount if you would like to make an additional donation to support the scholarship program.

6 Security Check

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7 Payment

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	To pay with check, please include a note that states which retreat you are paying for and mail to Siena Retreat Center 5637 Erie Street Racine, WI 53402 Your registration will be marked complete upon receipt of 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.

	By submitting payment, you authorise Siena Retreat Center to send instructions to the financial institution that issued your card to take payments from your card account in accordance with the terms of Siena Retreat Center's agreement with you.