Beyond Addiction Retreat in Peru

(Please print)

Registration Form

Name: ___________________________________________________________
Address:______________________________________________________________________ Postal Code:
_______________________
Telephone: (h)_______________________________(w) ___________________________________
Email: _______________________________________Fax: _______________________________________
Age:_______________
Profession:___________________________________________________________________________________
__
Describe previous experience with yoga
_____________________________________________________________________________
______________________________________________________________________________________________
______________________________
What is your background with addictions
______________________________________________________________________________
______________________________________________________________________________________________
________________________________

I would like to register for the Beyond Addiction Retreat in Peru, Cusco Sacred
Valley.
The retreat consists of 70 hours of teacher training and visits to sacred Inca sites.
Start: Saturday October 18th at 12.00 pm.
Ends: Tuesday October 28th at 9.00 am.
- Yoga costs: US$ 1850 (no tax) payable to Carole Galand (see info bellow)
- US$ 500 deposit is required to hold a space. Balance is required by August 18,
2014 deadline.
- Costs increases to US$ 2100 (no tax) after July 18, 2014.
Includes yoga program Beyond Addiction facilitated by Tej Kaur and Pavan Pal
Kaur
- Lodging, Meals and Excursions: US$1000 (no tax) payable to Atalaya,
http://www.atalayaperu.com, contact Magda Ruiz , upon arrival.
To Register: Please make out a cheque or money order to Carole Galand and send
it to:
Carole Galand
348 Palmerston Blvd
Toronto Ontario
M6G 2N6 Canada.

This completed form should be sent by mail, email or fax.

Before sending a fax, please call: Tej (Carole)
Space is limited. Please register early.
Payment by: Cheque Money order Master Card
Total amount: $ _____________________
Cancellation Policy: $500 registration fee is non-refundable. The remainder of the
retreat fee is fully refundable if written notice of cancellation is received before
August 18, 2014.
After this date, there is no refund possible.
Contact Tej (Carole):
__________________________
Phone: 1.647.725.7545
__________________________
Email: caroletej@gmail.com

Signature:
Date: