Sedona Retreat Order Form November 13th – 16th, 2024 Name First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email Cell NumberRetreat Ticket (per person) Price: Room Accommodations* ̶K̶i̶n̶g̶ ̶b̶e̶d̶r̶o̶o̶m̶ ̶(̶K̶i̶n̶g̶ ̶L̶a̶v̶e̶n̶d̶a̶r̶)̶ ̶Q̶u̶e̶e̶n̶ ̶w̶i̶t̶h̶ ̶p̶r̶i̶v̶a̶t̶e̶ ̶b̶a̶t̶h̶ ̶(̶J̶a̶d̶e̶ ̶R̶o̶o̶m̶)̶ ̶Q̶u̶e̶e̶n̶ ̶w̶i̶t̶h̶ ̶h̶a̶l̶f̶ ̶b̶a̶t̶h̶ ̶(̶Z̶e̶n̶ ̶r̶o̶o̶m̶)̶ ̶Q̶u̶e̶e̶n̶ ̶w̶i̶t̶h̶ ̶s̶h̶a̶r̶e̶d̶ ̶b̶a̶t̶h̶ ̶(̶G̶a̶r̶d̶e̶n̶ ̶R̶o̶o̶m̶)̶ ̶Q̶u̶e̶e̶n̶ ̶w̶i̶t̶h̶ ̶s̶h̶a̶r̶e̶d̶ ̶b̶a̶t̶h̶ ̶ ̶ ̶S̶h̶a̶r̶e̶d̶ ̶r̶o̶o̶m̶ ̶w̶i̶t̶h̶ ̶p̶r̶i̶v̶a̶t̶e̶ ̶b̶a̶t̶h̶ ̶(̶L̶a̶v̶e̶n̶d̶e̶r̶ ̶R̶o̶o̶m̶)̶ Shared room with private bath (Lavendar Room) Shared room with private bath (Sage Room) Shared room with private bath (Sage Room) Shared room with private bath (Sage Room) ̶T̶w̶i̶n̶ ̶w̶i̶t̶h̶ ̶s̶h̶a̶r̶e̶d̶ ̶b̶a̶t̶h̶ (Peace Nook) PLEASE NOTE: Room accommodations are limited. Reservations accepted on a first-come, first-served basis. Please be aware payment is due in full at registration and no refunds are available.Total $0.00 Credit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Expiration Date Security Code Cardholder Name Δ
