International Permaculture Design Course

Bosco Centre Wakerville

9- 19 December 2012

Please print clearly

fax to0867701467or type and mail to

ATTENDEE DETAILS

First Name:______

Surname:______

Date of birth:______

Gender: ______

Contact Number:______

Email Address:______

Dietary requirements:______

List any medical condition:______

Allergies: ______

Contact details in case of emergencies:

______

Occupation:______

Have you ever lived / worked on a farm,or have any permaculture experience

please tell us in brief about it:

______

______

What are your expectations:

______

Where did you hear about us:______

Please tick your option:

Chalet R6500Chalet R7000

(valid until 15 Oct)

Dormitory R6500Camp R6000

PAYEE / SPONSOR DETAILS

Company name:______

Billing address:______

______

______

Country:______

VAT / Registration number: ______

Contact person:______

Contact number:______

Email: ______

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“Early Bird Special” Chalet Option+ Course – valid until 15 October R6500

(limited to 20 pax)

  • Course and materials
  • Chalet accommodation 2/3 sharing
  • All meals and refreshments
  • Certificate
  • Pack Organic Heritage seeds

Chalet Option + Course R7000

  • Course and materials
  • Chalet accommodation 2/3 sharing
  • All meals and refreshments
  • Certificate
  • Pack Organic Heritage seeds

Dormitory Option + Course R6500

(limited to 10 ladies and 10 gents)

  • Course and materials
  • Shared dromedary (separate ladies and gents)
  • All meals and refreshments
  • Certificate
  • Pack Organic Heritage seeds

Camping Option + Course R6000

(limited to 10 pax, you will need to bring your own tent and bedding)

  • Course and materials
  • Camping site
  • All meals and refreshments
  • Certificate
  • Pack Organic Heritage seeds

Once registration form is complete an invoice for payment with banking details and reference number will be issued.

A list of requirements, venue regulations, map and further details will be sent once deposit is paid.

TERMS AND CONDITIONS

-This course is limited to 64 participants

-Course and printed material will be in English

-50% deposit required to secure booking

-Balance to be paid by 1 December 2012

-Should you wish to cancel we require written notice within 7 working days from 8 December 2012, there after all payments are non-refundable

-You are required to get yourself to the venue and back (please share lifts)

-Neither venue nor facilitators shall not be liable for any participant for personal injury, death, theft / accidents / damage to personal, property negligencewhat so ever,

Any further enquiries contact:

Courselogistics and accommodation

Candice 082 881 9336, ,

Coursefacilitation and material

Ewald082 856 5248,