Registration First Name Last Name Email Phone Address City State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip / Post Code Emergency Contact and Phone Number Hotel Accommodations Discounted hotel rates are: $209 double, $30/day resort fee waived for our event.) If you are planning to room with someone, please enter their name(s) here. If you will be looking for a roommate, post on the EBR Facebook page. Date of Arrival Date of Departure Select Occupancy Double Triple Quadruple Special Needs? Do you have any dietary restrictions? Please select your payment method: Paypal Credit Card Please select your payment option: One Payment Two Payments Three Payments If you select Paypal as your payment method, a Paypal invoice will be sent to the email address associated with your registration. If you select to submit payment with a credit card further details will be included in your confirmation email. In order to satisfy the contract with Tamaya, attendees must stay at the resort for the retreat. In order to receive Retreat rates, hotel reservations should be made as soon as possible. See your confirmation email for details. If you are a human seeing this field, please leave it empty.