Registration Form

* (denotes required field)

E-Mail Address:

Full Name: *

Age: *

Gender: Optional Question

Male Female Other

Mailing Address: *

City: *

State: *

Zip (XXXXX): *

Home Phone (xxx-xxx-xxxx): *

Cell Phone (xxx-xxx-xxxx):

Occupation:

Emergency Contact Name: *

Emergency Contact Phone (xxx-xxx-xxxx): *

Retreat/program you are registering for: *

Starting date of retreat/program: *

I will be driving to the ranch: *

Yes No

If you reserved the shuttle, please provide your travel information. If flying into the Albuquerque Sunport, we will need your airline, flight number(s), arrival and departure times. Or, please indicate that you wish to be picked up at the Hotel Santa Fe. Please confirm that shuttle service is available for your retreat. This information can be found in the description of your retreat on our Calendar of Events and Registration page. Detailed information about the shuttle schedule and cost can be found under Location and Getting Here.

I would like to make a reservation for the shuttle: *

Yes No

If you reserved the shuttle, please provide your travel information. If flying into the Albuquerque Sunport, we will need your airline, flight number(s), arrival and departure times. Or, please indicate that you wish to be picked up at the Hotel Santa Fe:

Travel Information:

I will provide my travel details later: *

Yes No

I would like to carpool if a rideshare is available in my area: *

Yes No

Special diet request: Meals at the ranch are hearty vegetarian and incorporate dairy and eggs. Please let us know if you have a special diet request. If you are requesting a special menu, please let us know what alternative foods you prefer to eat. Special diet requests automatically incur a $5.00 per day fee. No Exceptions.

Special Diet Request: *

Yes No

Do you have any physical health, mental health or mobility issues we should be aware of? (i.e. difficulty walking)

Physical or mental health issues: *

Yes No

If yes, please explain:

I want to pack light and rent the Ultimate Comfort Package for my stay at the ranch. Please reserve a sleeping bag, sleeping bag liner, sheet and pillowcase, towel and wash cloth for me. You must reserve your Ultimate Comfort Package in advance and include your payment with your registration

Comfort Package?: *

Yes No

How did you learn about Vallecitos?: *

I am an alumnus/a and have attended a retreat at Vallecitos before Santa Fe Reporter Santa Fe New Mexican Taos News KTAO Solar Radio Inquiring Mind Internet Friend None of the Above

If you heard about us from somewhere else please let us know:

Is there anything else you would like us to know?

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