Registration Form • 8 Gate 2 Master Cylinder

28 MAY - 7 JUNE 2009

Lake Titicaca: Peru and Bolivia

Please email your Registration Form and Photograph to

PERSONAL INFORMATION

First Name
Last Name
Starry Name
Address
Zip / Postal Code / City
State / Country
Date of Birth (month/day/year) / Home Phone #
Fax # / Cell - Mobile Phone #
Email Address
Passport Number / Country of Issue
Passport Expiration Date / Name on Passport (if different)
Nationality / Occupation
I have enclosed a recent photograph of myself (please check): / Yes / No

VISA INFORMATION
Peru and Bolivia require visas from some countries. Please contact the Peruvian and Bolivian Consulates or Embassies in your home country to find out if you need to get a visa for either country. Additional visa information on Peru and Bolivia is on the Nvisible Website on the 8th Gate 2 Master Cylinder Questions page.

SPECIAL NOTE: We will obtain visas for all USA citizens (unless you state otherwise) as this is the only way for US nationals to enter Bolivia without the yellow fever vaccination certificate. More info at VISA INFO in the 8th Gate 2 Master Cylinder Questions

I require a Peruvian Visa. / Yes / No
I require a Group 2 Bolivian Visa. / Yes / No
I require a Group 3 Bolivian Visa and I will need an official invitation to enter Bolivia. / Yes / No
I am a US citizen, but I want to arrange my own Bolivian Visa. / Yes / No
I already have a Bolivian Visa valid for at least six months. / Yes

PLEASE CHOOSE YOUR 8 GATE 2 MASTER CYLINDER PACKAGE:
Please note that there is a small number of single and triple rooms available

Room
(Choose one) / Single at $2100 USD / Double at $1622USD per person
Land Package
(Only for Peruvians and Bolivians who do not require accommodation) / (please check)
A non-refundable deposit of $500 is due upon confirmation of your registration.
50% of Total Amount is due by March 11, 2009
100% of Total Amount is due by May 1, 2009
AMOUNT PAID / BALANCE DUE / PAYMENT METHOD
ROOMMATES & FOOD
We cannot guarantee finding a roommate for you. In most cases we are successful. If not, you will be required to pay the additional room supplement costs.
My roommate choice is:
Please find me a roommate: / Male / Female / Either / Smoking OK / Non Smoking
Food Preferences: / Vegetarian / I eat fish & chicken. / I eat everything!

EARLY ARRIVALS
For people who want to arrive at the Hotel Libertador in Puno a few days early

Arrival date:
Type of Room
(choose one) / Single at $100 USD per night / Double at $50 USD per night, per person
My roommate choice is: / Please find me a roommate:

LATE DEPARTURES
For people who want to stay at the Hotel Libertador in Puno for an extra day or more

Departure date:
Type of room
(choose one) / Single at $100 USD per night / Double at $50 USD per night, per person
My roommate choice is: / Please find me a roommate:

8 GATE 2 SCHOLARSHIP FUND

There are always some key people who really deserve to be at the Master Cylinder, but do not have the funds to participate. They would be a brilliant and supportive addition to our One Being and their presence would greatly serve the entire Gate. Because of this, we have created an 8 Gate 2 Scholarship Fund to help with their expenses. All donations are deeply appreciated!

I would like to donate $______USD to the 8 Gate 2 Scholarship Fund. Please add this amount to my Grand Total.

SPOKEN LANGUAGES

My English is:
(Choose one) / Excellent / Good / A Little / None
First Language
Second Language
Third Language
I am willing to be a translator from English to ….

MY REASON FOR WANTING TO PARTICIPATE IN THE MASTER CYLINDER

I want to participate in the 8 Gate 2 Master Cylinder because…..
What do you want to receive from participating in the 8 Gate 2 Master Cylinder?
I have read the 8th Gate 2 Master Cylinder Questions, Visa Information and Master Cylinder Registration Information on the Nvisible website (please check): / Yes / No

PREVIOUS EVENTS

Please list all 11:11 events you have participated in, even if we are alreadyaware of it.

Master Cylinders:
Star-Borne Reunions:
Anchor Groups:
Workshops:

HEALTH & SPECIAL CONDITIONS

The energies at the Master Cylinder are often extremely intense. In addition to this, we will be located in an area of very high altitude, which can result in altitude sickness. High altitude can also create an additional strain on the heart, lungs / breathing, liver and other vital organs. If you have ANY special medical conditions, we must know about this before we can accept your registration. In some cases, a letter of approval from your doctor may be necessary.

Physical limitations / special conditions (please also include any heart / lung / liver related conditions):
Mental conditions:
I am currently being treated for:
I have recently been treated for:
I am using the following medical drugs:
I use drugs/narcotics (please check): / Yes / No
Other important information:
I take full responsibility for all medical costs, and related expenses, should I need medical treatment for any new or existing conditions during the entire period of the 8th Gate 2 Master Cylinder Preparations and Activation Ceremony (please sign full name and date):

EMERGENCY CONTACT

First Name
Last Name
Address
Zip / Postal Code / City
State / Country
Home Phone #. / Cell - Mobile Phone #.
Email
Relationship

BECOMING AN 11:11 WORKSHOP FACILITATOR

Participants for the 2009 11:11 Workshop Facilitator Master Class will be selected at the 8Gate 2 Master Cylinder.

Please note that the Master Class is by invitation only. Being part of the Master Cylinder is not a guarantee of being invited to the Master Class, but is a prerequisite for those who feel called to do this.

I would like to become or remain a Workshop Facilitator because….

TERMS & CONDITIONS

Star-Borne Unlimited & Solara and all its associates or employees, act only as the facilitators of this 11:11 8 Gate 2 Master Cylinder Conference. Neither Star-Borne Unlimited, Solara, or any of its associates or employees shall be liable for any delay, change in schedule, loss, damage or injury to property or persons caused by reason of negligence, wrongful or intentional acts, or for any expense or inconvenience caused by such circumstances or for any cancellations, refunds, change of schedule or disruption of any services provided during this 8 Gate 2 Master Cylinder Conference.

REFUNDS: except for the first $500 deposit, refunds can be obtained up until March 11, 2009. After that, there shall be no refunds unless we find someone to take your place.

CONDUCT: Illegal drugs, soft & hard including marijuana & hashish, are not appropriate to an 11:11 Activation. The use of them at this event will not be tolerated and if used, the participant will immediately be asked to leave the Master Cylinder Group.

Star-Borne Unlimited & Solara shall have the right to decline participation at any time in the 8th Gate 2 Master Cylinder Conference should any person's health, mental condition, physical infirmity or general deportment impede the operations of the conference or the rights, welfare, or enjoyment of other participants.

Star-Borne Unlimited & Solara and all its associates or employees, are not responsible for any physical, mental, emotional or other reactions, traumas or ailments, that participants may experience while working with the heightened energies occurring during or after the 8 Gate 2 Master Cylinder activities and preparations or from any lectures, workshops or sessions of any kind, including private sessions.

I accept full responsibility for my actions and in no way hold Star-Borne Unlimited, Solara, and all its associates or employees liable for anything I might experience.

I have read the Terms & Conditions and agree to comply with them.

(PLEASE SIGN HERE)

Signature: Date Signed: