Event Registration

2019 Cancer Retreat Application


  • $25.00



Please use this form to initiate your registration for a Cancer Retreat here at Harmony Hill. Once you have completed this form, a secondary and more extensive questionnaire about your health and well-being will be sent to you automatically. If you do not recieve an email with instructions to complete the secondary questionnaire, please check the spam folder of your email service.

Please complete this application and submit with the application fee. Within two weeks, we will contact you with confirmation of your registration in a retreat or your placement on the waitlist. 

Applications are accepted upon receipt of a $25, non-refundable application fee, payable by credit card (below). The application fee can be waived based on financial need. Please request a waiver by contacting us.

If you would like to manage your NeonCRM account (i.e., view and print donation history, update profile, etc.), please create a login name and password below. Your password must be at least eight characters long, and contain at least one number.
required fields

Thank you for submitting your application. Please do not hesitate to contact us if you have any questions about this process.