Participant Registration Form

Thank you for signing up for the 3-day aWALKening to Personal Leadership Retreat in Chesterfield, New Hampshire at the Hallelujah Farm Retreat this winter. Within a few days of completing and submitting this registration, you will receive an invoice. We will continue to be in touch with you leading up to the retreat in order to prepare you for this "moving" experience. 
We look forward to meeting you and spending this special time together - Kate Link & Marijne van den Kieboom

P.S. Please note - snowshoeing will be optional and as the weather allows. If you need to rent snowshoes, you will be provided with sites to contact for rentals. Rentals arrangements are on your own.

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1. Contact Information - If more than one person is in the registering party, each must complete this form.

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Select commuter rate or your choice of lodging - will be assigned first come, first served: (Note: Lodging includes 2 breakfasts, 2 lunches, 2 dinners and snacks.) NOTE: All rooms have shared baths.

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Select your method of payment: Cancellation Policy: Payments made will be refunded in full (less a $50 processing fee) if you cancel by January 16, 2017. If you cancel between January 17 and February 3, you will be charged $100 registration fee. No refund is available if you cancel after February 3 or leave the program early. Emergencies may be considered on a case-by case-basis.

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4. List any special needs you require (e.g., dietary restrictions, lodging, etc.):

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5. Your experience with walking and snowshoeing:

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6. What most interests you about the aWALKening Retreat? What do you hope to learn or experience?

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7. Would you like to --

  Yes Not at this time
Be placed on the aWALKening (Leadership 'N Motion) mailing list (we promise not to clutter your inbox)?
Donate $15 towards a scholarship to defray the cost for needful participants?

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8. How did you find out about the aWALKening Retreat?

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9. What questions do you have or what else would you like us to know about you?

By submitting this form you agree to the following:
1. I am in good physical condition and can walk a minimum of 4 miles in a day (possibly broken into two walks and always with different paces accommodated) with potential for uphill walking. I do not suffer from any known disability or condition which would prevent or limit my participation in this aWALKening Retreat for walking - even in snow.

2. I am in good physical condition and can snowshoe a minimum of two 45-minute blocks of time per day with potential for walking in deep snow. (Easier and shorter options are always available.) I do not suffer from any known disability or condition which would prevent or limit my participation in this aWALKening Retreat for snowshoeing and I recognize this is an optional activity.

3. I understand that the aWALKening Retreat experience builds community. It is important to commit to attending sessions and participating in order to maintain the power and integrity of the community for myself and for others. I agree to be present when the group is convening and participate in aWALKening Retreat activities. (I recognize there will be designated time in the schedule for myself and non-Retreat activities of my own choosing.)

4. I agree to arrive by 1:30pm on Friday, February 10 and stay until the aWALKening Retreat ends at 3:30pm on Sunday, February 12, 2017.

5. I come to the aWALKening Retreat with curiosity and openness. I am interested in learning more about myself and understand that this might not always be what's most comfortable. I come ready to see myself and my life from new - or renewed - perspective(s).