Registration Form

Name:                ___________________________________                                          Address: ___________________________________ ___________________________________ State:  _______      Zip:  _______________ Phone: Home:  ________________________ Work:  ________________________ Fax:     ________________________ E-Mail: ___________________________________ Please circle the program(s) for which you would like to register. "Spring Equinox" 3/21/10   ::  Cost: Donation according to means Summer Solstice "Hurray for Summer" 6/13/10   ::  Cost: Donation according to means "Climate and Water: Ecological Crisis, Spiritual Challenge" 7/8/10 - 7/11/10  ::  Cost: $285 "Insight Quest - Listening to Land and Sea" 8/30/10 - 9/2/10   ::  Cost: $285 Total Cost:  $________________ Make checks payable to:  “Stella Maris Retreat Center” I have the following needs:             _____  Room on the ground floor                                                           _____  Dietary considerations (please note)                                                           _____________________________ Please return completed Registration Form & Payment to: Stella Maris Retreat Center WATERSPIRIT 981 Ocean Avenue Elberon, New Jersey 07740