Healing Ground

Special Interest Form

Please use this form if you are interested in scheduling your own retreat or workshop

The River Birch Studio at Healing Ground is available for guided or unguided personal or small group retreats. It is a perfect way to nourish your body, mind and soul in the tranquil beauty of Healing Ground.

Name
Your E-mail Address
Home Address Line 1
Home Address Line 2
City
State
ZIP
Your Home Phone

Please complete this section if pertinent and/or different from above.
Company/Organization
Business Address Line 1
Business Address Line 2
City
State
ZIP
Your Work Phone

Request a special visit, workshop or retreat*

Date and Time Requested

Number of People to Attend

Equipment Needs

VCR
DVD
CD/Tape Deck
Flip Chart

Please send me a brochure

*For special requests, we will send you a price quote and hold your date, if available, for 10 days.