The Kushi Institute of Europe
Weteringschans 65
1017RX Amsterdam, NL
Tel.: +31 (0)20 625 75 13 Fax.: +31 (0)20 622 73 20
E-mail: www.macrobiotics.nl

Registration Form

The Art of Life School

Please mark X near to your selected course/s:

The Art of Life School - autumn 2014 special offer - second person 10% discount!

Level 1 October 1 – 13
€ 1395 (in Amsterdam) / Level 4 February 1 – 15, 2015
€ 1395 (in Amsterdam)
Level 2 November 1 – 13
€ 1395 (in Amsterdam) / Level 1 or 2 or 3 August 2 – 14, 2015
€ 1395 (in Helvoirt)


Special discounts for those attending several levels in 2014 - 2015

Level 1, 2 & 3 or Level 2, 3 & 4 one-time payment, only € 3495 classes taken within max. 2 years
Level 1 & 2 or 2 & 3 or 3 & 4 one-time payment, only € 2495 classes taken within max. 2 years

Prices include: classes, study guide, 3 warm meals per day,
free accommodation in a 2-3 person room with limited availability ( for Levels taken in Amsterdam )

1st person please write in capitals

Mr. / Mrs. / Miss
First name:
Family name:
Date of birth:
Address:
Postal code:
Town:
Country:
Tel. home:
Tel. work:
Fax:
E-mail:

2nd person

Mr. / Mrs. / Miss
First name:
Family name:
Date of birth:
Address:
Postal code:
Town:
Country:
Tel. home:
Tel. work:
E-mail:
For parents: During the Summer Conference, children are welcome. Please contact us for more information.

Language

All classes are given in English

I require translation into:

There are additional costs for this translation service.

We will contact you about the possibilities, after we receive your registration form.

Note: Please let us know immediately of any health restrictions such as special treatments, physical disabilities, medications, drugs or dietary restrictions.

Accommodation: For programs in Amsterdam
A limited number of free accommodations are available. When these are filled, we can help you to find other options like hotels, hostels, relatives in near surrounding = but extra costs needto be count with.
I want accommodation in a 2-3 person room
I do not need accommodation
Payment
I am making the required
non-refundable down payment of:
€ 350,- per person / Total:
€
I am paying the total course fee / Total:
€

Method of payment no cheques are accepted

Bank Transfer to the Kushi Institute
Bank ABN-AMRO Amsterdam
acct. no. 49.86.08.468
swift code: ABNANL2A
IBAN: NL77ABNA0498608468
Credit card / Visa / MasterCard
Credit card number:
Expiration date:
Last 3 digits on back of card:
Card holder name:
Date:
Signature:

Please return the completed form to us by email, fax or post.

We reserve the right to change dates and prices

In case of cancellation, more than 2 weeks prior to a course, full refund is granted except for the (non-refundable) down payment. Less than 2 weeks prior to a course, or if interrupting a course, no refund is possible.

The Kushi Institute is not a medical institution. The programmes and services of the Kushi Institute as well as the information provided on our web pages are for educational purposes. They are not meant as medical advice nor to take the place of a personal consultation, medical diagnosis or medical treatment.