REGISTRATION

for

Vision Quest

To register, fill out the Registration Form below and return it to us as soon as possible.

Your registration is complete ONLY when we have received all of the following:

  • A deposit (see below for amount).
  • Registration Form with signature (either electronic or actual signature), and notice of how you intend to make a final payment.
  • Complete the Health Questionnaire, Personal Release Waiver/Insurance & Emergency Contact form, and return all to Ursula Popp,(or 12252 2nd Ave NW, Seattle, WA 98177).

Programs are filled on a first-come, first-served basis. We encourage early registration to secure your place and to provide sufficient preparation time.

DEPOSITS/PAYMENTS

Vision Quest September 6 – 13, 2014: $1000 for the eight-day program, including fee for the guides, campground or lodge, breakfast and dinner. A non-refundable deposit of $200 for the Vision Quest by August 5.The remaining balance of $800 is due August 25th.

Please make all payments out to NHRC, and send to 12252 2nd Ave NW, Seattle, WA 98177.

PROGRAM CANCELLATION

If a minimum number of people are not registered ten days prior to the start date, the program might be canceled. If we cancel a program due to low enrollment, registered participants will be given a full refund. We ask that you do not make travel arrangements until given notice that we have full enrollment.

CANCELLATION POLICY

Please Read This Before You Register: Your decision to enroll represents a commitment to yourself and to us. Our cancellation policy is designed to support you with this commitment. During your preparation time, life may present significant obstacles (real as well as imagined, inner as well as outer) and it may seem impossible for you to proceed with Vision Quest. We ask that you register only when you are truly committed to attending. Please indicate your agreement and understanding by initialing the four statements below.

1. The deposit of $200 (Vision Quest) is non-refundable. ______Initial

2. Any funds paid over and above the deposit, will be refunded at the time of participant cancellation. ______Initial

3. Werequest that you abstain from recreational drugs and alcohol during the course of these programs, thereby supporting your full presence to both the nuances of your soul’s unfolding and to the co-creation of our group field. ______Initial

REGISTRATION INFORMATION

Date

Name

Address

City State Zip Country

Phone (Home) (Work) (Mobile)

Occupation Birth Date Gender

E-mail Web Address (URL)

How did you hear about Vision Quest?

Please indicate how you intend to make final payment.

By signing a completed registration form, you are acknowledging that you have read and agree to all of the policies listed above. If you wish to sign this form with an electronic signature (type in your name below) and send it back to us via email, you agree that your electronic signature is your signed acknowledgement that you have read and agree to all of the policies listed above.

Signature: ______