Registration
Form
To
register for the week in Mexico, please print out the form
below
and mail with your deposit to: (Choose
printer friendly version.)
Ann
Newsmith
57 Scott Road
Brattleboro, VT 05301
Name _____________________________
Address
_____________________________
_____________________________
Phone ___________________
(day)
_________________________
(eve)
E-mail
_____________________________
Name & age
of additional family members:
____________________________________________________
____________________________________________________
____________________________________________________
How
many rooms desired? ____
Single __ Double ___
Enclosed is:
___$ 250 non-refundable
deposit per room to hold our places.
___ $ _____
payment in full. (Please make checks payable to Ann Newsmith.)
Any physical
impairments:
____________________________________________________
Any dietary
restrictions/requests:
____________________________________________________
Has you traveled
abroad previously?
____________________________________________________
If yes, to
what countries?
____________________________________________________
Have you done
yoga previously?
____________________________________________________
Special interests:
____________________________________________________
Questions?
Call Ann Newsmith, (802) 257-4710
For
more information
call Ann Newsmith at (802) 257-4710, or e-mail
ann.newsmith@gmail.com
