Please note that attendees must register and pay in full 7 days prior to the program start date. Please let us know of dietary restrictions with this form.

All meals are served buffet style in our dining room.

The Mariandale Center reserves the right to cancel a program or retreat if a minimum number of registrants are not met. Cancellations by the Center are fully refundable.

If you want to pay by check, please fill/print this form out, and mail it with your check, payable to Mariandale, to:
The Mariandale Center
299 N. Highland Ave., Building 5
Ossining, NY 10562

OR, to Pay by Credit Card, please fill out and submit the form below.
Please enter the Retreat(s) and/or Program(s) in the spaces below: 
Retreat / Program 1  
Retreat / Program 2  

Pay a Deposit now ($25 for Day programs, $50 for Weekend programs, $75 for Week-long programs)

OR, Pay the full amount of the program fee now

I would like to add a donation to support Mariandale
Total amount:   $0.00  (U.S. Currency)

Credit Card & Check/Debit Card*

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Routing Number

Your Information
First Name *
Last Name *
Billing Address*
U.S. Phone
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* All payments provided to The Mariandale Center comply with U.S. laws and regulations.
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The Mariandale Center
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