Registration Form

Please register me for the May 25 - June 1, 2019 Iyengar yoga retreat in Ireland with Kevin Gardiner   

The workshop cost per participant is $2600 (or $2700 if reserved after January 10, 2019). The registration fee is $350 per participant with the full amount due on or before March 15, 2019. Please make your check or money order payable to “Late Wisdom” and mail it with the completed booking form below to:

Late Wisdom

P.O. Box 551

Flossmoor, IL 60422

NAME__________________________

ADDRESS________________________

CITY  ___________________________

STATE ______________  ZIP ________

PHONE ________________________

E-MAIL__________________________

                I have enclosed the registration fee of $350 with the balance due on or before March 15, 2019

                Note:  Refunds prior to April 1, 2019 will incur a $200 cancellation fee per participant.  After that refunds will be made only if a replacement can be found.  In the event the workshop is cancelled a full refund will be given.

I have studied________________________ yoga for _____ years with

_______________________________(primary yoga instructor).

My dietary concerns are: _______________________________

_______________________________

_______________________________

It is okay/not okay (select one) to release my name and e-mail address to other fellow participants on this trip so we might coordinate travel arrangements.

I have read and understand the information contained within the "Late Wisdom" web-siterelating to this retreat.

Signed:___________________________

Date: ___________