Online Registration Form For Registrants using PayPal

Sedona Mago Retreat   8/19-8/23  2010

Please fill out this registration form below and submit with your $300 deposit through PayPal

If you are mailing in your deposit payment, click here for printable form

Online Registration Form For Registrants using PayPal


Name

Address

Phone Number

Email Address

Accommodations: check your choice below

Double Single  Roommate(s)?

 - Please list roommate name/s below

Check below if you would like to be matched up with a roommate

Yes, I would like to be matched up with a roommate

Please list any physical limitations in the box below:

Registration Deposit payment made through PayPal 
using the cart button at the top of this page: $300.00

       

If you are mailing a check or money order, please print and fill out the 
registration form below and send it, along with your $300 deposit to:

Angelights
PO Box 7775
Cumberland, RI 02864 

To print - Highlight the registration form items below, click file>print and check "selection"

Registration for Sedona Mago Retreat 8/19-8/23 2010

 

Name          _______________________________________

Address      _______________________________________

                     
                  _____________________________________

Phone          _______________________________________

Email            ______________________________________

 

Accomodations:  Double______  Single_______

 

Roommate(s) 
______________________________________

                     
______________________________________

 

Want to be matched up with a roommate? _________________

 

Physical limitations___________________________________

 

Amount enclosed: Deposit of $300.00