REGISTRATION FORM

ABOUT MASTER YOGA 1-5: If you meet the requirements for Master Yoga 1-5 (see WORKSHOPS/REQUIREMENTS), BEFORE REGISTERING for the retreat, please send an email to questions@wncheart.info requesting to receive specific and additional requirements, information, and the Application Form. If you are applying for Master Yoga 1-5 for the first time, repeating MY1-5 or asking for a MY1-5 evaluation only, please fill out Application Form by January 20th. For first time applicants, your application fee will be included in your Deposit.

(If you are an active Reiki Tummo or Open Heart Coordinator, Regression Guide, Reiki Master, Open Heart Instructor or family of, a Lifetime Coordinator, or Committee Chair for this Retreat please use the Team registration form.)

LAST NAME:    FIRST NAME:

STREET ADDRESS:

CITY:     STATE/PROVINCE:

COUNTRY:    ZIP:

EMAIL:

HOME PHONE:    WORK PHONE:

CELL PHONE:

Please check any that apply:
STUDENT who is not working yet
(30% discount for all first-time workshops; no discount on repeat fee)

SENIOR who is 62 years or older
(25% discount for all first-time workshops; no discount on repeat fee)

I want to attend the following workshops:

	FIRST TIME	REPEAT
Reiki Tummo 3a This workshop is an abbreviated workshop intended for those who need to meet the requirement of RT3a (attunement) so they can attend Inner Heart and Spiritual Retreat. Repeat alumni welcome.	$250 $175 student $187.50 senior None	$25
Inner Heart	$200 $140 student $150 senior None	$60
Spiritual Retreat	$325 $227.50 student $243.75 senior None	$100
Master Yoga Preparation	$70 $49 student $52.50 senior None	$0
Master Yoga 1-1 (and Master Yoga 1-2)	$100 $70 student $75 senior None	$0
Mastering Reiki Tummo	$250 $175 student $187.50 senior None	$100
Master Yoga 1-3 (and Master Yoga 1-4) (These 2 workshops are paid together as one package of $200)	$200  $140 student $150 senior None	$0
Master Yoga 1-4 (This individual fee is only for those who previously only paid for MY 1-3 and not the full package for both MY1-3 and MY1-4)	$100 $70 student $75 senior None	$0
Open Heart 3	$175 $122.50 student $131.25 senior None	$60 $40 for those who already attended True Self or above
Open Heart 4	$200 $140 student $150 senior None	$70 repeat $50 for those who already attended True Self or above
MY 1-5	$400 $280 student $300 senior None	$225 repeat but not graduated $150 repeat and graduated
SUB TOTAL
TOTAL (of first time and repeat fees)
Registration and Deposit Due by January 29 2009 CONSENT FORM I understand and agree to the following: The workshops, their procedures, techniques, shown, used, discussed and/or demonstrated are for educational purposes only.  No part of these workshops is presented either directly or indirectly as a diagnosis or prescription for any health problems.  Persons with health problems should continue to seek appropriate professional help with qualified members of the medical profession.  Persons using the text procedures and practices do so for educational purposes only. Date:   Name: Terms of Use By clicking the I Agree button below, I certify that I understand and agree to these terms. I understand if do not agree to these terms, I should click the Cancel button, which will discontinue my registration for this Retreat.

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