Please print the page below or download
Word doc. here
REGISTRATION
FORM
for John Ogilivie's Yoga Healing Retreat
Awakening
Your Vitality
March 12-18, 2005
* Please contact Alison below
to ensure there is a place available for you before sending completed
form and payment.
Please PRINT or TYPE all information.
|
| Full
Name |
| Postal
Address |
| |
| |
| Daytime
Phone Number |
| Mobile/Cell
Phone Number |
| Email
Address |
| Would
you like to be included on our email mailing list? |
Costs:
|
Single $1,350US |
Twin Share
$1,200US |
|
Payments:
Your place is secured with a $500US deposit. There will be 20% deducted
for cancellations more than 30 days before the retreat commences. The
deposit is completely non-refundable less than 30 days before the retreat
commences. This deposit will go towards your total payment. The balance
is due at least 30 days before the retreat commences. |
Cheque
_______________( Amount Enclosed)
Please make cheque payable to" Vitality4Life" |
Credit Card Payment |
| Type of Card
|
| Full Name on
Card |
| Credit Card
Number |
| Expiry Date
|
|
|
|
Alison
Pearl |
61
2 66 845 570 |
|
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| |
| |