MAUI RETREAT Digital Registration Form

MAUI RETREAT - Digital Registration Form
(JANUARY 26 - FEBRUARY 1, 2002)

Name:
Address:
City: State:
Zip: Phone:
E-mail:

Deposit enclosed: $500 to reserve space
(Payable to Ballard Firehouse Studio)

(please check	one)
Dormitory Semi-Private (2-3) Private (limited space)		$ 950 $1,150 $1,395

Semi-Private Roommate Request:

Send us a note or request for further information:

$500 Deposit due with registration. Balance due by January 5, 2002.
Half of deposit refundable, if you cancel by Jan. 1, 2002.
After Jan. 2002, deposit nonrefundable.

Deposit enclosed: $500 to reserve space
(Payable to Ballard Firehouse Studio)

Send Registration and payment to:

Mary Bersagel (yoga retreat)@
1103 NW 63rd St.
Seattle, WA 98107
Inquires: 206-769-8102
www.FireHouseYoga.com