Laura Heine Registration Form August

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We are thrilled that you will be joining us for a fun-filled retreat Laura Heine event led by Vicki. Please complete the form. After you have filled it out, please contact Kim for payment of your deposit of $50. YOUR REGISTRATION IS NOT COMPLETE UNTIL THE DEPOSIT IS RECEIVED.

The Laura Heine Retreat is in August. Total price is $218 which is for lodging and the instructor fee.

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Email *

First name *

Last name *

Street address *

City *

State *

Zip Code *

Phone number *

Emergency Person Contact Name *

Emergency Person Contact Phone Number *

WAIVER: Attendee agrees to hold harmless HONEY HILL RETREAT (owner Kim Cotcher) to include all employees, contractors, instructors, vendors, and affiliates, for any damages, losses or injuries that may occur while traveling to/from or during/after the event/retreat, in classroom environment, touring the facility, and all areas within and/or on premise(s). I waive any/all claims for any personal injury, property damage or any loss sustained by me as a result of my participation in the HONEY HILL RETREAT (owner Kim Cotcher) event held on premise(s). By agreeing, I confirm I have read the above and agree to these terms, conditions, waiver, and release of liability. *

I agree and understand the above waiver.

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