Heart of the Mountain Retreat Full Name ___________________________________________ Phone ______________________________________________ E-mail ______________________________________________ Mailing Address ______________________________________ City _______________________________________________ State _________________________ Zip _________________ Please mail checks to: We can also accept credit cards - Master Card, Visa, American Express Card type: ____________________________________________ Card number: __________________________________________ Expiration date: _________________________________________ Space is limited so please register as soon as possible. Registration must be received before June 19, 2012 in order to receive the 10% discount. All payments must be received two weeks before the start of class. Workshop fees are non-transferable and non-refundable unless we are notified two (2) weeks in advance of the event. For questions or to register over the phone please call Valerie Donner, at The Ground Crew, 925-287-8976 or e-mail valeriedonner@sbcglobal.net You can also copy and paste this text into an email, fill in your information and send it to the above email address. Please call us as well to be sure we received your registration. To print choose Print Preview first and make changes to the settings so that this form will fit comfortably on one page. Thank you! |