Grace Cirocco

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Registration Form - TTS Intensive Retreat

1 of 2 Steps.

Date of Retreat:

Surname Name: First Name:

Address:

City:

Prov:

Country: Zip/Postal Code:

Telephone: (please include area and country code)

Cell Phone:

Work Phone:

Email:

Food Allergies:

How did you hear about this workshop?

Please specify DOUBLE OCCUPANCY OR SINGLE OCCUPANCY

Please note that assignment of rooms is on a first come, first serve basis. A deposit of $700 per person must be received to guarantee your reservation, as space is limited.

How will you be paying your deposit?

Paypal - (a secure online payment system that takes creditcards and debit)

By Telephone: Call our office 905-688-0868 Monday - Friday 9am-5:00pm and Retreat Co-ordinator, Leah Taylor will register you over the phone. If you're calling after hours, it's best to fill out the online registration form and pay your deposit by paypal which is the safest internet payment system in the world.

Cheque - (mailing instructions on next page)

If you have selected PayPal as your payment method, hit the Back button after you have submitted the registration form and click on the Buy Now PayPal button below. Thank you.

Questions? Call 905-688-0868 or email info@gracecirocco.com