New Year’s Eve Retreat 2010

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TO DOWNLOAD THE REGISTRATION FORM PLEASE CLICK HERE

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Registration Form

As a condition of participation in the New Year's Eve 2010 Residential Retreat (29 December 2010 - 2 January 2011), you are required to complete this Registration Form (separate forms must be completed for each adult and each child attending) and mail it to the address below, along with payment of the non-refundable deposit(s), or you can register online at: www.LouixNYE.org. Once registered, you will receive a welcome packet along with additional forms to complete, which will be e-mailed (or mailed) to you, including a Liability Waiver, Recording Release, and Medical Information Form, which must be completed as a condition of participation in the Retreat. The cost of the Retreat and accompanying payment schedule is the following:

All prices are in U.S. Dollars	Total Cost	Non-Refundable Deposit (upon registration)	2^nd Payment (15 Aug 2010)	Final Payment (15 Nov 2010)
Adult (single occupancy)	$2,895	$1000	$1000	$895
Adult (double occupancy)*	$2,295	$800	$800	$695
Child 12 - 18 Years (double occupancy)	$1,700	$600	$600	$600
Child 12 - 18 Years (sharing with 2 adults)	$1,200	$400	$400	$400
Child 4 - 11 Years (double occupancy)	$900	$300	$300	$300
Child 4 - 11 Years (sharing with 2 adults)	$400	$150	$125	$125
Child under 3 Years	Free	Free	Free	Free
*Room sharing requests may be made in the welcome packet. We will endeavor to honor, but cannot guarantee, all such requests.

Registration fee includes: 5 days, 4 nights, double occupancy stay at The Lodge at Torrey Pines; all vegan meals throughout the retreat; all gratuities; valet parking; access to spa facilities; a celebratory dinner on New Year's Eve; as well as all discourses and ceremonies with Louix Dor Dempriey. The pricing above does NOT include: items of a personal nature, spa services, sundry expenses incurred during your stay at the venue, travel and travel-related expenses to and from the retreat.

Please register me for the Residential Retreat with Louix Dor Dempriey from 29 December 2010 - 2 January 2011. All monies are due in accordance with the schedule above and all payments other than the non-refundable deposit are refundable until 15 August 2010, after which there will be no refunds of any kind, for any reason whatsoever. Please note that refunds may take up to 45 days to be issued.

Legal First Name: Last Name:

Preferred Name:

Address:

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Country:

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Please provide your payment information below.

Please charge my credit card the following amount: $

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By submitting this form, I do hereby release Louix Dor Dempriey Foundation and all its assigns from all liability for any reason and/or circumstances whatsoever arising before, during, and/or after the Retreat as outlined in any advertising materials and any and all forms related to this Retreat. I also acknowledge that I understand the terms and conditions under which I am registering for this Retreat, this form is legally binding, and I am over the age of eighteen*. My attendance at this Retreat is not guaranteed until this completed Registration Form, the Recording Release, Liability Waiver, Medical Information Form, and full payment are received by the Louix Dor Dempriey Foundation. I do hereby consent to having my name, voice, image, and likeness recorded and used for commercial purposes.

* Please complete below if participant is a minor: I am the Parent or Guardian of the minor named above and have the legal authority to execute this release on behalf of the abovementioned minor.

Guardian Name :

For more information, please contact Samantha:
Phone: (888) 288-3735
E-mail: samantha@Louix.org