To register for the
October, 2010 Retreat in Lenox, MA

Please enter your registration details below. If you wish to register more than one person for the same retreat, you will have the option to return here after completing your registration.

Fields with an asterisk (*) are required.

First Name*:
Last Name*:
Address*:
Address - line 2:
City*:

State/Province:
Zip/Postal Code*:
Country*:
Email*:
Phone:

Date of Birth*:
(mm/dd/yy)

Male Female

Please describe any special needs
or medical conditions:

Is there somebody you would like
to share a room with?

How did you hear about this retreat?

If you selected "other" please describe:

Have you ever been on an retreat with Andrew Cohen?

Yes No

Are you eligible for one of the following discounts?

I am a Practicing Member

I am a university student

Accommodation preference:

Tuition & Meals Only (Accommodation on your own) (Total: $485)

Please note that all sessions with Andrew Cohen are audio taped and often video recorded. These recordings are copyrighted by EnlightenNext and may be used for various purposes. Your image or words may appear in our material and your registration implies agreement with this practice. If you notify us in writing at registration that you prefer to have the greatest amount of anonymity and confidentiality possible, all efforts will be made not to feature your image in a close-up or use your words prominently in any material distributed to the general public. Due to the nature of group events, however, we cannot guarantee absolute compliance.

To register for the October, 2010 Retreat in Lenox, MA

To register for the
October, 2010 Retreat in Lenox, MA