Subtle Creations
  • Retreat Registration

Please complete the following form. Items marked with an asterisk are required.

First Name: *
Last Name: *
Phone:


E-mail: *
DOB (MM/DD/YY):


*
Address:
City:
Province / State:
Postal Code / Zip:
Country:
If you have a web site, what is it?
Special Needs (physical or dietary accommodations):
Emergency Contact Name:
Emergency Contact Number:


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** Remember to print a copy of the e-mail you receive and send that along with your check to the address below. If your payment is not received your registration will not be considered complete.

Vikki Favreau
c/o Subtle Creations
26 Peter Street West
Kenora, Ontario
P9N 3R2 Canada

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