Your Creative Self Retreat-Registration
     
 
First Name*
  
 
Last Name*
  
 
Email*
  
 
Cell Phone*
  
 
Address*
  
 
City
  
 
State
  
 
Zip*
  
 
Country*
  
 

Food Allergies or Restrictions*

(Put none if you have no food allergies.)
  
 
  I understand I should wait to buy plane tickets until the website confirms that the retreat will occur*
 
  I understand that if I cancel by Feb. 15, my registration fee less 20% will returned.*
 
  I understand that if I cancel by March 1, my registration fee less 50% will be returned, and that there are no refunds past March 1.
 
Paying by
 

Check: Mail to address below.

Credit card: Fax to 360-678-8473

Credit card: Call 360-310-0361 to leave credit card info.

 
 
 
 

ART
Box 538
Coupeville, WA 98239