Reservation & Release

Download TERMS AND CONDITIONS (pdf)                  Download RESERVATION (pdf) 
 

RETREAT PRICE: Retreat price is $TBD(cash, cashier's check, bank drafts, or money order payments) or $TBD (credit card) per participant, including roundtrip airfare and accommodations. Airfare for the 2018 India Sacred Retreat is provided by United Airlines Group department.
 

RESERVATIONS/DEPOSITS: Payments for the 2020 India Sacred Retreat (the “Retreat”) must be received by the dates indicated below:
 

Registration and $1,000 Non-Refundable Deposit Due: May 1, 2018
Payment in Full Due: July 10, 2018

 

A $1,000 non-refundable deposit per person will secure space ($1,042 if paid by credit card). The balance is due by July 10, 2018. Retreat space is limited, and reservations will be based upon date of participants' registration and deposit. If registrations exceed available Retreat space, priority will be given to the earliest postmark dates on deposits received.
 

RELEASE/RESPONSIBILITY: The Retreat Organizer and its representatives will have no responsibility or liability for any delays (including delayed departures or arrivals); missed airline or other carrier connections; injury, loss, or damage to persons or property (including luggage), unless it results from the negligence or willful misconduct of the Retreat Organizer or its representatives; or additional expenses resulting from changes in exchange rates, tariffs, or itinerary. By signing this Retreat Participant Agreement, the participant releases the Retreat Organizer and its representatives from any such responsibility or liability. The liability of common carriers, including liability for lost luggage, is generally limited by applicable law. Participants are strongly encouraged to purchase cancellation, luggage, and accident insurance. The Retreat Organizer reserves the right to accept or reject any Retreat participant at any time without liability and without any obligation to pay a refund or any other amount whatsoever. The Retreat Organizer will have no responsibility or liability for any participant who leaves the Retreat prior to its conclusion or for any activity undertaken by any participant which is not included on the Retreat itinerary.
 

I/we have read and understand the Retreat Participant Agreement/Terms and Conditions for the 2018 India Sacred Retreat and, by making my/our advance payment as set forth below, agree to the terms thereof.


Please reserve my/our space.


_________________________________________________________                _____________________
Signature                                                                                                                                                      Date


_________________________________________________________                _____________________
Signature                                                                                                                                                      Date

Please Print:

Name: ____________________________________________________      Circle One:     Male     Female 
(as it appears on passport)


Passport Number: ____________________________ Expiration Date: ______________ Nationality: ___________


Name: ____________________________________________________      Circle One:     Male     Female 

(as it appears on passport)


Passport Number: ____________________________ Expiration Date: ______________ Nationality: ___________


Address: ________________________________________________________________________________


City/State/Zip: ____________________________________________________________________________


Country: ________________________________________________________________________________


Telephone: Day ( ______)______________________ Evening ( ______)________________________________


Email: __________________________________________ Fax: ( ______)____________________________

 


Emergency Contact Name: ________________________________________ Relationship: __________________


Emergency Contact’s Phone #1: ________________________________ Phone#2: _________________________


Emergency Contact Address: __________________________________________________________________


Emergency Contact E-mail: ___________________________________________________________________


Do you have any medical conditions or physical/mental health issues at this time? ___ yes ___ no 
If yes, please explain:

________________________________________________________________________________________

 

________________________________________________________________________________________

Additional airline courtesy information:

 

Name: _______________________________________ United Airlines Frequent Flyer # _____________________


Special Meal Request: _______________________________ Seat Request (if available): ______________________



Name: _______________________________________ United Airlines Frequent Flyer # _____________________


Special Meal Request: _______________________________ Seat Request (if available): ______________________


Group Orientation meeting date (see Terms & Conditions for more information on the Group Orientation meeting) for the 2018 India Sacred Retreat is: MONDAY, August 20, 2018 at 7pm at Porticos Apartments (party room) 500 W. Bradley Road, Fox Point, Wisconsin. Please check one of the following:

____I will attend the meeting

____ I will not be able to attend the meeting, and I understand that I am responsible for arranging Skype/Facetime and/or reviewing meeting video online. Please the group meeting video link to my e-mail address: 

________________________________________________________

 

PLEASE SELECT ONE OF THE FOLLOWING PAYMENT OPTIONS:
 

A) Enclosed is a cashier’s check, certified check, or money order (U.S. funds only):
In the amount of: $____________________, as (check one) ____ payment in full ____ nonrefundable deposit for the 2018 India Sacred Retreat. NOTE: Check or money order should be made payable to WELLNESS MATTERS, LLC.

 

B) I wish to charge my credit card: Type of Card: __________________ In the amount of: $___________________,
as (check one) ____ payment in full ____ nonrefundable deposit for the 2018 India Sacred Retreat. My credit card number is: 

_____________________________________________   Expiration: ___________ Billing Zip Code: ___________

Credit Card 3-digit (on back of card) or 4-digit code on front of American Express cards: ____________   

(You may also pay by phone- call 414-510-6662)

Registrations will not be processed until deposit is received.

 

Complete, sign and return this entire Reservations and Release form (download printable version) with your payment to: 
2018 India Sacred Retreat, c/o Wellness Matters, LLC, 500 W. Bradley Rd. #A-331, Fox Point, WI 53217, Attn: Ragani.
Upon your acceptance, an acknowledgment receipt of your payment will be sent to you.

Your answers to the following questions will help us to know a little about you.
 

Is this your first trip to India?  Yes   No

Have you participated in Kirtan with Ragani?  Yes    No   
Have you participated in Kirtan with Kaita?  Yes   No

 

* See Retreat Participant Agreement/Terms and Conditions for Retreat price inclusions and exclusions.

 

Copyright 2018 - Wellness Matters, LLC

© 2020 by Wellness Matters, LLC.
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Tel: 414-510-6662
       414-412-2473

6789 N. Green Bay Ave., Glendale, WI 53209

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