Springwater Center Retreat Application
Please submit one application per retreat.
Fields marked with a red asterik require a response.
Please read the Info and Policies section of the Retreats page of the web site. If more information is needed please contact reception - email@example.com.
Select the retreat you would like to attend:
Select an answer
Apr 28-May 1 2017 (3-Day Retreat with Stew Glick)
May 13-20 2017 (7-Day Retreat with Wayne Coger and Sandra Gonzalez)
June 10-17 2017 (7-Day Retreat with Stephan Bielfeldt)
Jul 1-8 2017 (7-Day Retreat with Richard Witteman)
Jul 21-25 2017 (4-Day Retreat with Les Schaffer)
Aug 12-19 2017 (7-Day Retreat with Bob Dattola)
Sep 2-9 2017 (7-Day Retreat with Sandra Gonzalez and Susan Schepp)
Sep 23-30 2017 (7-Day Retreat with Richard Witteman)
Nov 11-18 2017 (7-Day Retreat with Sandra Gonzalez)
Dec 29 2017-Jan 2 2018 (4-Day Retreat with Wayne Coger)
How many days of retreat will you attend as a Non-Member?
Select an answer
1 Day (Non-Member, Shared Room)
1 Day (Non Member, Private Room)
2 Days (Non-Member, Shared Room)
2 Days Non-Member, Private Room)
3 Days (Non-Member, Shared Room)
3 Days (Non Member, Private Room)
4 Days (Non-Member, Shared Room)
4 Days Non-Member, Private Room)
5 Days (Non-Member, Shared Room)
5 Days (Non Member, Private Room)
6 Days (Non-Member, Shared Room)
6 Days (Non-Member, Private Room)
7 Days (Non-Member, Shared Room)
7 Days (Non Member, Private Room)
Select an answer
Address Line 2
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Bosnia and Herzegovina
British Indian Ocean Territory
Central African Republic
Democratic Republic of the Congo
Republic of the Congo
Papua New Guinea
Saint Kitts and Nevis
Saint Vincent and the Grenadines
Sao Tome and Principe
Trinidad and Tobago
United Arab Emirates
United States Minor Outlying Islands
Virgin Islands, British
Virgin Islands, U.S.
Phone: please provide cell phone number if you have one. If you have no cell phone, please provide a phone number where we can reach you.
ARRIVAL AND DEPARTURE
Please make travel arrangements, whenever possible, to arrive at the Center by 2 P.M. on the day of retreat.
Rides are available only from 8 a.m. to 8 p.m. If you are scheduled to arrive after 8 p.m., or if your arrival is delayed past 8 p.m. please arrange other accommodation for the night. Rides are not always available once retreat has begun, and are not available on Mondays following retreat. Please contact reception to check for ride availability before applying for retreat.
If requesting a ride, it is helpful to provide your cell phone number in the space above. You may receive a message from the Center person who will pick you up. Call the Center if your arrival is delayed. Be sure your phone is turned on after your arrival in case we need to contact you about a change of ride arrangements.
Do you need a ride to or from Rochester airport, train, or bus station? (A donation of $40 each way for this service is suggested, which covers only part of the cost of providing it.)
Select an answer
No ride needed
One way ride
Round trip ride
How will you arrive? (Include flight number if by plane; train number if by train)
How will you depart (Include flight number if by plane; train number if by train)
CANCELLATIONS AND REFUNDS
Please let us know as soon as possible if you need to cancel. If a retreat is full and we cannot accept your application, we'll refund the entire fee. If you cancel more than 48 hours before retreat begins, there will be a cancellation fee of $50. If you cancel within 48 hours of the start of retreat, we reserve the right to retain the entire retreat payment.
We serve a vegan menu with egg and dairy options. If you have special dietary needs, please bring your own supplies. A refrigerator is available to store participants' personal food. Please do not use matches, candles or incense. Smoking is allowed only in the parking lot area. Please do not use scented sprays or toiletries.
Do you have any disabilities, health problems, or allergies that we should know about for assigning your retreat job or room?
If you have attended retreat before and prefer a specific job, please let us know. (Many factors affect job assignments and we can't guarantee to meet your request, but we'll do our best.)
Participants are housed 2-4 to a room.
Single rooms are an additional $210 for a 7-Day Retreat (prorated at $30/day for shorter retreats).
Please contact us - firstname.lastname@example.org - after you submit your application to reserve the single room option.
Please let us know if you snore loudly or are sensitive to others snoring. If so, please consider a single room. They are generally available at the single rate. See above and contact reception - email@example.com for availability.
Have you attended a retreat at the Center previously?
If no, how did you learn about us?
Please consider donating to the Retreat Assistance Fund, which helps people in need to attend retreat. Indicate the amount of your donation here:
I would like to receive news updates of future retreats.
Add me to the News Update list
Please use this space for any other comments.
We'll receive your application as soon as you choose a method of payment and click the "Proceed to Payment" button.
Paying by check will help support the Center by avoiding credit card fees. Send your check in the mail to Springwater Center, Financial Office, 7179 Mill St. Ext., Springwater, NY 14560
If paying online, fill in the credit card information on the credit card page that appears.
Your application will be accepted if there is space in the retreat and once payment has been received.
I will pay by check sent in the mail
I will pay online
I will apply for retreat assistance
I will contact you to make arrangements
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