Registration

Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone*
Email*
Requested dates for use of the Hermitage
Arrival date
MM slash DD slash YYYY
Departure date
MM slash DD slash YYYY
Will you be in need of spiritual direction?
- Yes
- No
Have you had a previous hermitage experience?
- Yes
- No
Emergency contact name*
First Last
Emergency contact phone*
Suggested stipend, donation:
- Irene Hermitage: $30.00 over night and $25.00 for the day
- Cobb Cottage: $25.00 for the day
- Illuminata House: $15.00 for a half day, $30.00 full day, $50.00 overnight
After the application is received, please expect a phone call contacting you about the stay.

Arrivals: no later than 3:00 pm
Departures: at noon

For Irene Hermitage, please let us know if you are in need of a morning and evening meal.

Meals $7.00 per meal. You may bring your own food.