In
order to secure your place, please fill in the appropriate
information and mail us this form. *Please advise us here
immediately of any allergies or physical limitations (also
fill out the attached Medical Release):
PLEASE COMPLETE
FOR EACH PERSON IN YOUR PARTY (Use a separate sheet if needed):
I.
Name:
Date of Birth:
/
/
- dd/mm/yy
M
F
Address:
City:
State/Prov.
Zip Code:
Country:
:(If outside USA)
Tephonel(Day):
Email:
II.
Name:
Date of Birth:
/
/
- dd/mm/yy
M
F
Address:
City:
State/Prov.
Zip Code:
Country:
:(If outside USA)
Tephonel(Day):
Email:
PRICE & WHAT’S INCLUDED: * Prices shown are per person double occupancy
rates. Add $150 per day for Single Occupancy.
Prices include EVERYTHING (except airfare): accommodations, all meals, the daily
TAI CHI for Health instruction, DVD & Book, and the SPA day. Airfare and
personal expenses (supplies, phone calls etc.) are not included.
* INSURANCE:
We strongly recommend that you obtain travel insurance. Please inquire.
RESERVATIONS: A Non-Refundable $500 per
person deposit is required to reserve your place. Balance
is requested 60 days prior to your scheduled week. Registration
deadline is two weeks prior to the retreat workshop.
METHOD OF PAYMENT:
Total Vacation
Amount $
Deposit
$ (required to register)
Full payment
$
CHECK
VISA/MC
American
Express
Discover
Acct.
No.
Exp. Date
Sec. Code
MAIL OR FAX REGISTRATION TO: INNER WORLD JOURNEYS, INC -
2829 Bird Avenue, Suite
5, PMB 242 Coconut Grove, FL 33133 USA
Tel: 305-598-8368
(Toll Free: 800-766-2390) Fax: 305-598-8369
CANCELLATIONS & REFUNDS:
NUMBER
OF DAYS PRIOR TO TRIP START DATE
CANCELLATION
FEE PER PERSON
60+
$500 (non-refundable
deposit)
59-31
50% of trip
price
30-0
No refund
LOW ENROLLMENT POLICY:
Inner World Journeys, unlike most companies, does
not cancel your vacation due to low enrollment. If
it occurs that there is not a sufficient number of
people to operate the retreat program, we will transfer
you into another program where there is a sufficient
number as well as space to accommodate you. This saves
you the risk of having to cancel a trip. There are
no penalties. The only financial obligation would be
to pay or receive credit for the difference in retreat
costs. It is very rare that Inner World Journeys needs
to transfer anybody but it can happen during certain
dates and, therefore, this policy serves to protect
all Inner World Journeys travelers.
EMERGENCY INFORMATION: Please provide us
with 2 emergency contacts:
Name:
Telephone:
Name:
Telephone:
RELEASE AND ASSUMPTION OF RISKS
PHOTO / VIDEO RELEASE: Inner World Journeys
occasionally videotapes and photographs guests and
activities for promotional use. Please notify us if
we are not free to use images of you or your group.
* If produced, Inner World Journeys would be happy
to provide you with photos or video clips where you
are present.
WAIVER – RELEASE AND ASSUMPTION OF RISKS:
By signing and dating this registration form you agree
that IN WITNESS WHEREOF, the Release and Assumption
of Risk is executed and presented to Inner World Journeys.
I acknowledge that I have voluntarily applied to Inner
World Journeys (a Florida company registered as a seller
of travel, registration #ST-31693) and that Inner World
Journeys relies in part on others to provide transportation,
personal excursions, accommodations and teachings.
I
further herein acknowledge and agree to accept any
and all risks of delay, unanticipated events, illness,
injury, emotional trauma or death and agree to release
absolve, indemnify and hold harmless Inner World Journeys,
Inc., its organizers, sponsors, shareholders, representatives
and employees from any injury or loss caused by or
resulting from the accommodations or employment of
any and all independent contractors. I have carefully
read this Agreement, understand that I am releasing
certain legal rights that I otherwise have and enter
into this agreement freely and voluntarily. I understand
that Inner World Journeys, in accepting my registration
to attend, does so based on this representation.
REQUIRED SIGNATURE: If not already
paid, I undertake to pay the remaining balance 60 days
before the scheduled
week. By signing
below, I agree to the terms and prices of the cooking
course vacation as stated above and grant permission
to Inner World Journeys to process (if paid by credit
card) the remaining balance no later than 60 days prior
to my/our vacation start-date.
