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We will not give your email to third parties and you can unsubscribe at any time.Website 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 Phone Please select the Gathering you are interested in attending* Hollyhock, Canada - May 2019 (International Gathering) Please select which most describes you* I am representing an established center I am representing an emerging center I am visioning a new center I am independent and interested in holistic centers Have you attended a previous Holistic Centers Gathering?* Yes No Please enter details of your participation in previous Gatherings, if applicablePlease advise how you heard about the Centers Gathering* Google search Facebook Twitter Previous participant Word of mouth HCN newsletter Please select the topics that interest you most* Marketing and Social Media Education and Programming Governance and Decision Making Staffing and Volunteers Finances and Fundraising Leadership and Communication Successes and Challenges Sustainability and Spirituality Sightseeing and Culture Please include any additional topics of interestPlease select the optional activities you're interested in* Sailing - afternoon CAD$105 Kayaking - afternoon CAD$85 Hiking - afternoon (included) Yoga - morning (included) Rowing - morning (included) Massage and Healing Arts (varied pricing) Please advise your room preference* Dorm room Standard Twin room - Shared Bath (for two people) Standard Double room - Shared Bath (for a couple) Standard Single room - Shared Bath (a single supplement will apply) Premium Twin room - Private Bath (for two people) Premium Double room - Private Bath (for a couple) Please note single rooms are limited. To accommodate 60 participants we encourage you to be flexible and consider sharing a room, to deepen the learning and bonding experience!If you are travelling with a partner or friend and would like to share a room please advise their name Please advise your dietary requests* Vegetarian Vegan Fish (no meat is served) Wheat free Gluten free Dairy free Sugar free No special requests We will pass on this information to each venue in advance of the Gathering. However please note we're unable to guarantee all dietary requests can be met in the various locations. Please ensure you talk to reservations at time of booking and also the organiser at the start of the Gathering and they will do their best to advise you of the options. Pre-Gathering Workshop* Yes No Maybe Please express your interest above in A Hidden Wholeness: Courage & Renewal Dan Hines May 8 – 12, 2019 on Cortes Island Please advise your travel arrangements* I'll make my own travel plans to Cortes I'm interested in the group travel option from Vancouver to Cortes Please include any other relevant information you would like to shareCommentsThis field is for validation purposes and should be left unchanged. Share this:FacebookTwitterPinterest