EXPLORING THE MASCULINE, MEN’S RETREAT

Saturday & Sunday, Nov 22-23, 2008

Registration Form

Name_________________________________________________

Address_______________________________________________

________________________________________________

Phone(s) _____________________ ______________________

Email_________________________________________________

Sleeping Preference: Tent_________ Indoor Bed__________

Special Needs? _________________________________________

Please bring with you:

Slip-on shoes

Clothes

Flashlight

Toilet articles, towel

Personal Journal, Drum (optional)

Please print and complete this form, and send it with your check.

Or you can email the form to info@gainesvillemenscenter.com

Please send check for $245 new men / $225 returnees to

Eric Diamond, Ph.D.,
4131 NW 28^th Lane, Suite 6
Gainesville, Fl 32606

To discuss special arrangements or for any questions, call Eric at 352-375-3001.