Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

Country

(###)

###

####

Please place me on the wait list for this program *

Yes

Are you interested in finding a roommate? *

Yes

No

My roommate and I prefer

One Bed

Two Beds

I prefer a single room if available

Please indicate your preference for a single room in either the Main House or Opus House. You will be contacted regarding availability.

Yes in the Main House for an additional fee of $370 SOLD OUT

Yes in Opus House for an additional fee of $140 SOLD OUT

No

Payment

The full registration fee of $800 is due when we are able to accept you into the program.

$800

Agreement *

Registrations are not transferable. All cancellations must be made in writing and received by February 1, 2019 for a full refund less a $50 processing fee. Cancellations received from this date to April1 receive a full refund less a $200 processing fee. There is NO REFUND for cancellations received after this date. In the event that the program is sold out with a waitlist and we are able to transfer your registration to someone on the waitlist, we will issue you a refund less the processing fee. If you leave the program for any reason, there is NO REFUND for unused services. 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. By registering for this retreat, participants specifically waive any and all claims of action against Dennis Patrick Slattery, Toni D’Anca, and Truchas Peaks Place 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 CANCELLATION POLICY FOR THIS PROGRAM.

Yes