Registration Form

Movements Retreat 2010 - Corfu

	New Participant
	Old Participant
First Name & Last Name
Address
Phone
Fax
E-Mail
ACCOMODATION:
	Single Room: € 610 (10 nights)
	Double Room: € 560 (10 nights)
With
	Onsite with your own tent or in Movements Hall: € 450 (10 nights)
RETREAT FEE:	The deposit fee of 200 US / 150 € is paid:

	In a money order or bank draft to Amy Silver, payable to Movements Retreat
	By Wire Transfer to: Movements Retreat P.O. Box 285 Charles Town, WV 25414, USA Bank of Charles Town 111E. Washington St Charles Town, WV 25414, USA Routing Number: 057001418 Account Nr: 7500391
	By Bank Transfer to: Ulrike Boess Hamburger Sparkasse - Germany IBAN: DE26 2005 0550 1139 774978 BIC: HASPDEHHXXX

	Please ensure that bank transfer fees are covered. Your registration is confirmed upon receipt of the seminar deposit. The remaining 340 US (in US Dollars) is due upon arrival.
	Declaration: Hereby I commit to participate in the Movements Retreat from June 12 - June 22, 2010. I acknowledge the conditions of participation and assure that I am able to be responsible for myself during the time of the Seminar.