Toni D'Anca Consulting

Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

Country

(###)

###

####

I plan to stay at Hotel Santa Fe *

Room rates include a $10 Breakfast Voucher redeemable in Amaya.

Yes

No

Are you interested in finding a roommate? *

We will do our best to connect you with someone, though it is not a guarantee. We recommend that you make a reservation to hold a room.

Yes

No

I plan to attend the following included meals *

Thursday Dinner

Friday Lunch

Saturday Lunch

Dietary Requirements *

None

Vegetarian

Vegan

Gluten Free

Other (please explain)

I am fully vaccinated and have my Covid booster *

In order to keep everyone safe, proof of vaccinations including boosters is required to attend this workshop. Please bring your vaccination card with you.

Yes

No

Payment *

The full registration fee of $450 is due at the time of registration.

$450

Agreement *

Registrations are not transferable. All cancellations must be made in writing and received by April 12, 2022 for a full refund less a $50 processing fee. There is no refund for cancellations received after this date. If you leave the program for any reason, there is no refund for unused services. If the program is cancelled or postponed, we assume no responsibility for participant’s cancelled air tickets or other prepaid transportation arrangements. Should the program require rescheduling due to unforeseen circumstances, all registrations will be moved to the new dates. Cancellations will receive a full refund less a $50 processing fee. By registering for this program, participants specifically waive any and all claims of action against Dennis Patrick Slattery, Toni D’Anca, and Hotel Santa Fe for damages, loss, injury, accident, delay, or death incurred by any person in connection with the program. No responsibility is accepted for losses or expenses due to sickness, weather, strikes, wars and/or other causes. In the event it becomes necessary or advisable for any reason whatsoever to alter the schedule or arrangements, such alterations may be made without penalty. If the program is cancelled or postponed by us, due to enrollment level or other unforeseeable circumstances, all fees will be refunded in full. If the program is cancelled or postponed, we assume no responsibility for participant’s cancelled air tickets or other prepaid transportation arrangements. I HAVE READ AND AGREE TO THE TERMS AND CANCELLATION POLICY FOR THIS PROGRAM.

Yes