Coming Home Registration Stage 2 In order to complete your registration for the retreat to Land of the Medicine Buddha, we just need a little more information about you. Please scroll down and fill out the form so we can learn more about you: If you have trouble with this form or have additional questions, you can contact Laura by email at email@example.com or on 1-800-611-5144 (toll free in the US and Canada). Land of the Medicine Buddha Registration Form Name* First Last What first name would you like on your nametag?Please answer the following:What's your birthdate?Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920How will you be getting to the Land Of Medicine Buddha?Are you interested in carpooling?What’s your experience with writing?What's your experience (if any) with yoga?Are there any medical or health issues that are relevant to your participation in this retreat? If so, please explain below.Do you have any special food needs?If you’re in a shared room, is there a particular person you’d like to request as a roommate?In case of emergencies, who should we contact? And what is their contact information?How did you learn about this workshop? (Be as specific as possible).NameThis field is for validation purposes and should be left unchanged.