Online Registration

First Name: Required

Last Name: Required

Address: Required

City: Required

State/Province: Required

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Work Phone:

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Check All That Apply:
Reiki Practitioner
Level 1
Level 2
Master
Reiki Master Teacher

Other Healing Modality:
Energy Work
Holistic Therapy
Massage
Yoga
Other
None of the Above
Interested in Learning More

Years in Practice:

Will you be camping out or staying in a building?
Building
Camping
If you select camping you are acknowledging that you will be bringing your own camping equipment to stay outdoors, and that you are taking full responsibility for your own safety, cleanliness, and comfort.

If you selected Building above rank your lodging preferences in order of 1 through 5 with 1 being the most desireable, 5 being least desirable.
This link to Ronora Lodge opens a new window to help you make your choice.

Building: 1 2 3 4 5
Ranch House
Trilogy
Grandma's House
Plant House
Cedar I and II

Are you a Vegetarian?
Yes
No

While we make every effort to provide a range of food choices to accomidate the group, if you have special dietary and health related restrictions that require differenct food selections, please bring whatever you need to supplement to menu and keep yourself well nourished.

There are full rustic kitchens in all houses that you are welcome to use (and clean).

Will you be participating in the Sweat Lodge?
Yes
No

If you will be bringing any children, how many?

If bringing children please list their names and ages below

In the spirit of cooperation:
The cost for the 2008 Midwest Reiki Convergence is at the same rate or lower than last year with an extra day and overnight stay this year! (meals included) To keep your cost as low and reasonable as possible, the staff at Ronora Lodge and Retreat Center is honoring our commitment to provide volunteer time to assist in various chores around the campground. (weeding the garden and/or labyrinth areas, clearing any debris, moving wood piles, cleaning cabins, 'extra' kitchen duty, etc.)

I am able to volunteer 3 hours of my time as an energy exchange to help with work that fits my ability. I understand that this is not mandatory and my choice will not prevent me from participating fully in the Convergence.
Yes
No