REGISTRATION FORM-June 8-21, 2011 Retreat

(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
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
Mastering Reiki Tummo	$250 $175 student $187.50 senior None	$100
Open Heart 5	$225 $157.50 student $168.75 senior None	$75 $50 for those who already attended True Self or above alumni to repeat
Open Heart 6	$250 $175 student $187.50 senior None	$85 repeat $60 for those who already attended True Self or above alumni to repeat
Mastering Reiki Tummo ++	$300 $200 who are MY1-5 or TSR alumni and have attended Health Retreat or Trusting & Loving True Source Retreat or Special Retreat $180 student $180 senior None	$200
True Self Preparation	$125 $75 student $75 senior None	$50
True Self Retreat	$400 $240 student $240 senior None	$130
SUB TOTAL
TOTAL with discount based on amount spent $400-799 = 10% off $800-999 = 15% off and over $1000 = 20% off (of first time and repeat fees)
Registration and Deposit Due by May 15 Balance due June 1, 2011. You may also send entire amount in one check now.	Please fill out Consent Form below to continue registration.
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. Print Please print a copy of this page for your own records, as you will not be able to return once you click 'I Agree'.                           ONCE ONLINE REGISTRATION HAS BEEN CLOSED and if you would still like to register, please contact us here: questions@wncheart.info *Note: If you have any questions, or need to update your registration after submission then please reach us at questions@wncheart.info To avoid confusion, please do not re-submit multiple times!