Iyengar Yoga in the Napa Valley
6 Day Iyengar Yoga Retreat
with Jaki Nett
Please print this Registration Form and complete and mail or FAX to us.
Our mailing address and FAX number are listed below.
• $600.00 for the 6 Day Iyengar Yoga Retreat
or
• $300.00 for Weekend only
• Add $50.00 to above costs for registrations after July 20th, 2012
• A deposit of $200.00 US (for the 6 Day 6 Retreat)
• or a deposit of $100.00 for the Weekend portion
will hold your reservation,
with balance Due: July 25th, 2012 |
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| NAME: _________________________________________________________________ |
| ADDRESS: _______________________________________________________________ |
| CITY / STATE / ZIP : ______________________________________________________ |
| COUNTRY : ______________________________________________________________ |
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NAME (as it appears on card) : __________________________________ |
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BILLING ADDRESS : _________________________________________ |
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CITY / STATE / ZIP : __________________________________________ |
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COUNTRY : _________________________________________________ |
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CREDIT CARD TYPE ( VISA or MASTERCARD) : __________________ |
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CREDIT CARD # : ____________________________________________ |
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EXP. DATE : _________________________________________________ |
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Please make check or money order payable to: |
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