Survivors of Incest Anonymous 

We Define Incest Very Broadly


for adult survivors of childhood sexual abuse

NY Intergroup 6th Annual Retreat

  • 21 Aug 2014
  • 24 Aug 2014
  • Kirkridge Retreat Center, the Poconos


Optional Extra Day: This year we'll be offering early arrival on Thursday afternoon/evening for those who would like to

have an extra day of unstructured fellowship or simple relaxation in this beautiful setting. Optional SIA WSO Conference

enrichment group discussions will take place for those who would like to participate on Friday (mid-morning & afternoon).

PLEASE NOTE: Thursday arrivals must register by July 1, 2014.

We hope to be able to accommodate everyone, and room reservations will be on a first-come first-served basis. We will

confirm receipt of your registration form via email and an information packet will then be emailed to you so please be sure

to include your email address (and check your spam folder). All questions can be directed to


Registration by email is encouraged: you will find a downloadable online form at: that you can return in

any of 3 ways: 1) fill out by computer, save & return by email attachment to, 2) fill out this form by

pen, then scan it and return by email and 3) fill out this form then return with deposit by traditional (snail) mail.

A $50 nonrefundable registration fee is required to hold your place

This payment can be made via PayPal to: And don't forget - to avoid added fees you must use your

PayPal balance or linked bank account for this transaction or else select the "Friends and Family" description when

asked: “What is this payment for?” Please bring a check or cash to the retreat for any outstanding balance, as we cannot

process payment cards on site.

If you require registration through US mail please fill out this form and send it along with a check/money order and a

SASE (Self Addressed Stamped Envelope - the info packet is hefty so please use 2 stamps) to:

SIA NYC, PO Box 7413, NY NY 10150.

mail registration for Friday arrivals must be postmarked no later than August 1, 2014.

E-mail or snail

SIA New York Intergroup presents its 6th Annual Retreat

August 21st - August 24th 2014 - Arrival and Registration begins at 3:00pm

Kirkridge Retreat Ctr., Bangor, PA.


Questions? E-mail

This year we have created a registration form that is a little longer and more detailed than in the past. Please provide as

much info as possible to help us in planning a memorable retreat. The information in the first half of the form is required.

The second half is optional but really helpful.


3 day (Thursday – Sunday): $350 shared room - includes all programs & meals ($500 for single rooms)

2 day (Friday – Sunday): $250 shared room - includes all programs & meals ($350 for single rooms)

Day tripper rate (without Kirkridge lodging): $80 a day includes all programs & lunch and dinner.

Name: Email: Phone #: Address:


Day, time, location of SIA home group:

Please indicate what day and time will you be arriving at Kirkridge (x):

I will be arriving on Thursday at approximately:

I will be arriving on Friday at approximately:

I will be attending on Saturday only (day tripper)



My deposit of $50.00 is being paid via (x):

Paypal and I will pay the remaining balance upon arrival (check or cash only)

US mail


I am including full payment online via Paypal

I am including full payment via US mail

I wish to donate to SIA world service organization and I am enclosing an additional gift in the amount of : $

Will you be driving to the retreat and if so, do you have space in your car to carry a fellow traveler (x)?


No, I'm coming via public transportation.

Yes, I'm driving but I don't have extra room

Yes, I'm driving and I do have extra space, I can fit

additional attendees.

You’ll receive detailed directions for travel to Kirkridge in the follow-up welcome packet or at


Lodging facilities are dorm style with two or three beds per room and centrally located shared bathrooms.

Please place me with the following roommate(s):


I do not have a preference. Please select a room for me.


I am requesting a private room: (There are limited numbers of single rooms available (see pricing above on

a first-come first-served basis. However, there are no private ensuite bathrooms.)

A leisurely continental breakfast with coffee/tea will be offered self-serve style in your lodging facility before the start of workshops. Participants are asked to help keep the kitchen clean, wash their own dishes, turn off the coffee pot, etc, after eating. Lunch selections are listed below. Dinner will be served buffet style in the dining room with options to please everyone. You may also bring snacks to share or food items needed for restrictive diets/medications, etc to store in the refridgerator.

Please circle one choice from the options listed below for each day of attendance.

Three Cheese Combo Hummus with or without Feta AND

Select 1 bread choice: Whole Wheat

Choices (Please type or write): __________________________ ______________________

Egg Salad
Vegetarian Greek Salad

Select 1 bread choice: Whole Wheat

Choices (Please type or write): __________________________ ______________________

Dinner will be served buffet style in the dining room with options to please everyone.
PLEASE NOTE: There will not be a potluck on Friday evening this year. We will be having our event fully catered by the Kirkridge culinary staff throughout the weekend. However, feel free to bring any needed food with you and snacks you'd like to share as you will have access to a small kitchen in your lodging facility.

Help us spread the word!

Please print out and share this flyer at meetings or email as appropriate to anonymity traditions to SIA fellows! Thanks you for taking the time to help us make this a powerful & healing retreat!


We have a great lineup of participant lead workshops & events this year in addition to plenty of time for fellowship and relaxation. Let us know how you'd like to participate by providing any of the following information:

TALENT SHOW: Sign up and claim your 3-4 minute time slot so that we can fit in as many participants as time allows

Would you like to share an alternative talent with the group (x)? Do you have artwork, or poetry, a photograph or sculpture, doodles or prose? Anything goes at our SIA Art Show! Bring something with you from home or create something new during the weekend in our art shop. Items will be displayed on Saturday evening after dinner and before our Talent Show

This year we will have an ArtShop area set aside during the retreat to create art and for art related workshops.


The Relaxation area is a space dedicated to reflection and relaxation throughout the retreat and where we will also hold yoga and other body movement workshops. There will be yoga mats, rollers, and therapy balls as well as recorded meditations and other shared resources/tools that you can test out. Do you have something that might be suitable for use in our corner?

On Saturday evening we will gather around the fire for a ceremonial healing circle (weather permitting). Using sound and movement we'll raise collective energy to release constraints and open to greater healing & fuller lives.

We will once again be setting up a ShareSpace table (see full description below*) Almost anything that's been helpful for you in your recovery - a new strategy, a favorite book or technique that has brought you insight and healing. It could be a written affirmation, a website, favorite podcast, a journaling practice, an audio meditation, deep breathing technique, or even a short video clip on an ipad/laptop. You do not have to provide any instruction. Materials will stay in the area and not be lent out, and

Would you like to perform in our Saturday evening Talent Show (x)?

Yes, I would like to share my talent of:

Yes (Please provide a basic description/size of item to display)

I will bring:

Do you have art supplies you would like to donate for use during the weekend?


I have the following items that I can bring:

Yes, I will bring:

We need drums, rattles, tambourines, or other percussive instruments.

Yes, I have this/these instrument(s) I can bring to the healing circle:

at the end of the retreat each person will take home their contribution to the ShareSpace.

for the ShareSpace info corner? (x). Yes, I do have something to share with others that has been of benefit to me.

Would you like to bring something 


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All rights reserved.  Permission to reprint granted only in writing.

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