PROGRAM REGISTRATION FORM

CDR’s Executive Development Retreat
July 7th – 12th, 2011
Zoëtry Paraiso de la Bonita, Riviera Maya

Full Name: ______(First name for badge) ______

Guest’s Full Name (for Resort): ______

Organization: ______

Preferred Mailing Address:______

City: ______State/Province: ______Zip/Postal Code: ______

Country: ______Telephone: (______)______Fax: (____)______

Email: ______

CONFERENCE FEES

1.  Registration Fees (All fees listed in U.S. Funds.) Includes assessment, executive coaching sessions, workshops, fitness or health risk evaluation session, reception, snacks/beverages, banquet, materials and proceedings.

Executive Development Retreat (including pre-work) r $4,500

If you have already had feedback with the CDR 3-D Suite, please check here

So that we can coordinate your 360° Leader Scan™ input process and feedback. r

2.  Special Group Zoetry Resort Rates for CDR Executive Development Retreat

All inclusive ocean front room at Zoetry, includes SPA EXPERIENCE

$1360 per person double occupancy (balance after deposit to be paid to Penny Sheldon Travel by May 6th)

$2100 per person single occupancy (balance after deposit to be paid to Penny Sheldon Travel by May 6th)

For more information and FAQs, go to: http://www.cdrassessmentgroup.com/retreat.php

3.  Trip Insurance: We strongly encourage participants and their guests to purchase travel insurance suggested by the group travel agent. To review this policy, go to http://content.travimp.com/quest/pdf/cfartpp.pdf. Please note that travel insurance must be purchased at the time of booking which would be the March 4, 2011 deposit date. For more information, please contact Penny Sheldon Travel at 888-336-8133 or at

4.  Cancellations/Changes and Refunds: All fees are non-refundable. Substitutions may be considered if the pre-work is not completed (assessment and coaching feedback session in advance of the Retreat.)

Deposit Required by: A $1,500 deposit is due by March 4, 2011 ($1300 applied toward CDR Retreat assessment and first coaching session; and, $200 to be applied for Zoetry room deposit.) PAYMENT METHODS: CDR accepts Visa or MasterCard payments. For the deposit of $1500, Check or Money Order must be in U.S. funds payable to: CDR Assessment Group and received no later than March 4, 2011. There will be a $25.00 fee charged on checks returned by the bank due to insufficient funds. Registration confirmation/receipt and further information will be mailed.

Please check appropriate box: r Check r Money Order

rVISA r MasterCard

Card #: ______Exp.:______

Print Cardholder Name: ______

5.  Final payments are due by May 6, 2011. Final payments to CDR will be $3,000 for the Executive Retreat participant and $1,260 per person double occupancy made payable to Penny Sheldon Travel for Zoetry Wellness & Spa All Inclusive Resort and Spa Experience. Penny Sheldon Travel accepts all major credit cards. Fees do not include airfare. When booking airfare, you will need to provide the travel agent or the airline with your exact name as it appears on your passport and your date of birth.

6.  Waiver of Liability and Disclosure of Host Company & Agency

CDR Assessment Group, Inc. (CDR) is acting as host of this training event and Penny Sheldon Travel (PST) is acting as a mere agent for SUPPLIERS (identified on the accompanying documents) in selling travel-related services, or in accepting reservations or bookings for services that are not directly supplied by this Travel Agency (such as air and ground transportation, hotel accommodations, meals, tours, cruises, insurance, etc.). PST and/or CDR, therefore, shall not be responsible for breach of contract, failure to comply with any laws such as the Americans with Disabilities Act (ADA), or any intentional or negligent actions or omissions on the part of such suppliers, which result in any loss, damage, delay, inconvenience or injury to travelers or travelers companions or group members. PST and/or CDR do not guarantee any of such suppliers rates, bookings, reservations, connections, scheduling, or handling of baggage or other personal effects. PST and/or CDR shall not be responsible for any injuries, damages, or losses caused to any traveler in connection with terrorist activities, social or labor unrest, mechanical or construction failures or difficulties, diseases, local laws, climatic conditions, abnormal conditions or developments, or any other actions, omissions, or conditions outside the PSTs or CDRs control. Traveler assumes complete and full responsibility for, and hereby releases the PST and CDR from, any duty of checking and verifying any and all passport, visa, vaccination, or other entry requirements of each destination, and all safety and security conditions of such destinations, during the length of the proposed travel. However, we specifically recommend that U. S. Citizens traveling internationally do so with a valid U. S. Passport.

For information concerning possible dangers at international destinations, contact the Travel Advisory Section of the U. S. State Department, (202) 647-5225, or access the State-Departments on-line travel advisory service www.state.gov/travel information/travel warnings). For medical information, call the U. S. Centers for Disease Control (CDC), (404)332-4559 or log on to www.cdc.gov/travel. By embarking upon his/her travel, the traveler voluntarily assumes all risks involved in such travel, whether expected or unexpected. Traveler is hereby warned of the above risks as well as possible travel industry bankruptcies and medical and climatic disruptions, and the possibility traveler may be unable to travel as scheduled because of personal emergency. Traveler is advised to obtain appropriate insurance coverage against these risks; information is available through PST regarding travel insurance Travelers retention of tickets, reservations, or bookings after issuance shall constitute a consent to the above and an agreement on his/her part to convey the contents hereto to his/her travel companions or group members.

Please mail or fax completed Registration Form with DEPOSIT payment to: CDR Assessment Group, Inc.

Phone: (918) 488-0722, Rebekah Garrett Executive Retreat

FAX: (918) 488-0721 1644 South Denver Avenue

Email: Tulsa, OK 74119

Please fax or telephone credit card information. Do not email credit card information because security cannot be guaranteed.

For final payment on the Resort due by May 6, 2011, please contact:

Penny Sheldon Travel

(888) 336-8133 or (208) 336-8133

website: www.PennySheldonTravel.com

For additional information, go to www.cdrassessmentgroup.com to access .pdf brochures, FAQs, and more.

______Registrant’s Initials (Acknowledging that you have fully read and understand the terms of this Retreat Registration Form)

______Date Initialed

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