Program Registration

Please submit one registration per person and per program.

To register online just fill in the form and hit the submit button at the bottom of this page.

The items marked by the ASTERISK (*) are required for the registration process.

To move from field to field use the tab key or place your cursor in the next field with the mouse.

IF YOU DO NOT RECEIVE CONFIRMATION WITHIN TWO DAYS, PLEASE PHONE OR MAIL IN YOUR REGISTRATION. THANK YOU.

Credit Card Payment Option »

To pay the deposit/program fee with a credit card, PLEASE FOLLOW THIS LINK (it will open in a new window), provide the information as requested, AND THEN RETURN TO THIS PAGE and complete the form before submitting your registration.
Begin Registration Here

* Name:
Attendee's Name (if different):
* Address:
* City:
* State:
* Zip Code:
* Email Address:
* Phone Where You Can Be Reached:
* Please tell us what dates, or retreats, or information you are interested in:

If there is a choice of directors for a directed retreat, please indicate up to two choices below:

Please tell us if you have any dietary requirements:

If paying by credit card, PLEASE be sure to provide credit card information -- see directions above in RED. Upon receipt of this deposit, please charge the remainder of the fee to this credit card number::
Pay in Full
Additional Information:
I request a handicapped accessible bed room Include me on your mailing list I will send a CHECK, payable to Mariandale Center, as a non-refundable, non-transferable deposit to hold my place in this retreat. I would like more information on Mariandale Retreat and Conference Center. This is my first participation in a Mariandale program. Sign me up for a wellness session (additional cost) Send more information on wellness services.

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299 North Highland Avenue • Ossining • Westchester County • New York 10562 • 914-941-4455