GODDESS REVEALED

September 19-26, 2015 held in Tuscany

Please fill out a registration form for each person attending.

*Last Name: Middle Name:

*First Name:

*Email: Secondary Email:

*Home Phone: Cellphone: Work Phone:

Street Address: City:

Prov./State: Postal Code/Zip:

Special Rate if you book before August 10, 2015
Double Rate $4500.00 per person
Single Rate $5500.00 per person
(flights not included)

Bookings after August 10, 2015
Double Rate $5200.00 per person
Single Rate $6200.00 per person

$1000.00 deposit to be paid by August 10, 2015

Balance of Payment to be paid in full by August 14, 2015