Roots to Wings Registration

Please tell us about you:

First Name:

Last Name:

Address1:

Address2:

City:

State:

Country:

Phone:

Postal Code:

Fax:

E-mail:

Please check the box next to the workshop and the date for which you would like to register:

Kirtan with Dave Russell -

Price:

$20

	Days of the Week:
	S M T W T F S

Date Range:
Start: October 1st	End: October 1st

Time:

7:30pm

Fall 2011 Children's Classes -

Price:

$125

	Days of the Week:
	S M T W T F S

Date Range:
Start: September 13th	End: November 17th

Time:

Varies

Living Healthy Workshop -

Price:

$185

	Days of the Week:
	S M T W T F S

Date Range:
Start: October 21st	End: October 23rd

Time:

Fri 6-9pm; Sat/Sun 1-5pm

Finding True Self -

Price:

$325

	Days of the Week:
	S M T W T F S

Date Range:
Start: Saturday May 5th 2012	End: Sunday May 6th 2012

Time:

TBA

Heart Opening Workshop -

Price:

$25.00

	Days of the Week:
	S M T W T F S

Date Range:
Start: TBA	End: TBA

Time:

TBA

Aging Successfully -

Price:

$20

	Days of the Week:
	S M T W T F S

Date Range:
Start: TBA	End: TBA

Time:

1-3pm

We Accept Visa and MasterCard. Please enter your credit card information:

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Expiration Date:

Amount to be Charged on your card:

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