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Registration Form
Discover Happiness Adventure - Hawaii 2006
March 11, 2006 - March 19, 2006

This Registration Form and a $500 non-refundable deposit are required in order to reserve a space in Discover Happiness Adventure - Hawaii 2006

* Denotes required fields


Name: *

Street: *

City: *

State: *

Zip: *

Home Phone: *

Work Phone: *

E-Mail Address: *

Event Fee: $2000

Please complete one of the following two choices:

Choice One:

Check I am enclosing a check (made out to Connected Lifestyles*) for:

		Entire Event Fee of $2000
OR
		Deposit of $500, along with post-dated checks covering the balance of $1500 (must be paid in full by February 1, 2006)

Choice Two:

PayPal I am using PayPal to deposit funds to the bank account of Connected Lifestyles:

		Entire Event fee of $2000
OR
		Deposit of $500, to be followed by payments covering the balance of $1500 (must be paid in full by February 1, 2006)

Registration Choice One (Use one of the three options below)

Mail Registration Form and check(s) to Connected Lifestyles, address below
Fax Registration Form to (310) 450-4074 and mail check(s) to address below
E-Mail Registration form to carol@carolsegrave.com as an MS Word attachment and mail check(s) to the address below

Please make checks payable to CONNECTED LIFESTYLES.

Registration Choice Two (Follow both steps below)

Pay using PayPal - click on the button below and follow the instructions to make a payment. You will be able to select the dollar amount, giving you the option to pay in full or pay only the deposit.
Submit Registration form in one of three ways: Mail Registration Form to Connected Lifestyles (address below) OR Fax Registration Form to (310) 450-4074 OR E-Mail Registration form to carol@carolsegrave.com as an MS Word attachment

  Mailing Address:

  Carol Segrave
  Connected Lifestyles
  1941 Euclid Street # 4
  Santa Monica, CA 90404

  Contact Carol:

E-Mail: carol@carolsegrave.com Telephone: (310) 450-4074

The cost of the event is $2000 per person and includes all scheduled island ground transportation, lodging, meals (except for two lunches out on the town where you can discover and taste local pleasures), field trips, yoga and meditation classes, workshop sessions, snorkel gear and guides. Fee does not include air fare, drinks or any unscheduled transportation. A non-refundable deposit of $500 will reserve your space. The balance is due by February 1, 2006.

Contact Carol at (310) 450-4074 or at carol@carolsegrave.com to set up a scholarship or monthly payment plan.

CANCELLATION POLICY
Cancellations must be made by phone and confirmed in writing to Carol Segrave. If you cancel your reservation more than 30 days prior to the start of the event, we will retain your non-refundable deposit of $500 but return the balance to you. If you cancel fewer than 30 days prior to the start of the event we will retain your entire payment. This forfeited payment can, however, be applied to another event within one year.

Connected Lifestyles reserves the right to cancel an event at any time. Should this be necessary, your entire payment will be refunded to you.

Your signature indicates that you understand and agree to the above terms and conditions.

Please sign and date:

Sign:

Dated:

*Connected Lifestyles is the name of Carol Segrave's consulting firm.

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