Spirit of the Mountains Retreat
REGISTRATION FORM – ESOTERIC HEALING 2010

Name _____________________________________________________________________________

Address ___________________________________________________________________________

City _______________________________________State____________________Zip____________

Telephone: ______________________________ Cell_______________________________________

E-mail:_____________________________________________________________________________

Date of completing / sending this form: _________________________________________________

How did you hear about this class? _________________________________________________________
Please mark the appropriate class selection below:
Registering for: Part 1 – August 27-31, 2010 _____ Part 2 - Sept. 10-14, 2010 ______


REGISTRATION OPTIONS:
(Please check one of the following)

_____ $100 deposit (non-refundable) to reserve your place. Balance of $300 to be paid prior to 2 weeks of class start date.

_____ $400 registration fee paid in full

_____ $200 repeat fee (proof of documentation of prior Esoteric Healing 1 class taken)
*Please note $30 late fee for all registrations received within 2 weeks of class start..
.
On-site Lodging Option: See lodging details at www.spiritofthemountains.net
(Reduced rates for on site lodging available for out of town/state student guests – limited availability)

_____ I am interested in on site lodging at Spirit of the Mountains during this class. I understand I will be sharing a multilevel luxury cabin with others. (Reservation payment due in full 2 weeks prior to class)
Select preference below:
_____ Private bedroom / bath suite - $450 for 5 nights ($90 per night) OR
_____ Lower level full size bed with ½ bath, shared upstairs shower – $350 for 5 nights ($70 per night)

_____ I will share my bedroom with my friend _________________ also taking the class
($60 each per night - $300 each)

_____ I will be commuting from home or staying elsewhere during this class.

PAYMENT METHOD:
(Please select one)

_____ Check or Money Order – Made out to Coral Thorsen or Spirit of the Mountains
Mail to Coral Thorsen, Spirit of the Mountains, 120 Russell Circle, Penrose, NC 28766

_____ VISA or Master Card (circle one)
Name as it appears on the card: (Please print) __________________________________________________

CC #___________________________________________________Exp. date:________________________

Signature_______________________________________________________________________________
**To pay by credit card over the phone, call: (828) 885-8353 or (941) 266-8860 (cell)