Registration Form

    Basic Info


    Personal Development & Questions?


    ​Travel for the Shenandoah Workshops

    ​Select Your Rewiring Program

    Dietary Restrictions

    Please note we may not be able to accommodate all dietary needs, we’ll let you know if you’ll need to supplement with your own foods.   


    ​Additional Information

    Deposit Payment Options
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    Once you have completed this form please click the
    "Submit" button to finalize your registration