At Stillpointe Wellness Center
in Belleville, Illinois
March 23, 24 & 25, 2012
Printable
OFFLINE REGISTRATION FORM
Name_____________________________________________________Street Address____________________________________________
State/Province & Zip Code_________________________________
Phone___________________________
E-mail___________________________
Vegetarian____ Regular____ Special_________
A non-refundable Deposit of $75.00 is required to hold space
Deposit ($75)____
Paid-in-Full Registration ($160)____Check____ (Payable to CIRCLE STUDIOS)
Money Order____ (Payable to CIRCLE STUDIOS)
Visa or Mastercard #:_____________________________________Name:____________________________________Exp:____________
Will arrive:___________________
Need directions_______
Send the original, fully completed Registration Form to:
The Flute Discovery Retreat
c/o Peggy Hill
200 Medicine Way
Eureka Springs, AR 72632