Lehua Enterprises LLC   PO Box 922 Volcano, HI 96785      healing@9innerjewels.com

Registration Form

Name(s)____________________________________________
Address_____________________________________________
Phone ___________________________
E-mail ___________________________
I will be attending ____3 Days ____7 Days ____ 10 Days
Would like to share a room with: ___________________________
(Please note that all of our rooms are non-smoking.)
Diet: All food will be freshly prepared meals. (If you have any special dietary
needs, please explain. We will do our best to accommodate you.)
_________________________________________________________________
_________________________________________________________________

I would like to reserve a space for the following retreat.
_______Retreat Date _________________________Retreat Title
___ Deposit Only ___ Complete Retreat Fee
Deposit: $150.00 per person (non-refundable, required to hold space)
Check____ (Payable to Lehua Enterprises)
Money Order____ (Payable to Lehua Enterprises)
Online through PayPal____
I would like to pay the balance of my retreat fee by
Check____ (Payable to Lehua Enterprises)
Money Order____ (Payable to Lehua Enterprises)
Online through PayPal____
The balance is due 30 days before the start of your retreat.
______ Retreat Payment
______ $100.00 Single Room Fee
______ Airport Transfer

$50.00/each way per person
Will arrive: _______________ If you need airport pick-up, please book your flights to arrive between 9-8:00 PM.
Need airport pickup_______ (Additional $50.00 per person each way. ½ price for an additional person.)

Need directions_______ Send them e-mail____ or regular mail____
 
Mail directions to:_______________________________________

Send the original signed registration form to:
Lehua Enterprises PO Box 922 Volcano, HI  96785. We will mail your confirmation package as soon as we receive your registration form. For questions please call 808-333-4514. Your package will include all relevant information including directions, a general information form, brochure of the Big Island, and a release form which needs to be signed and returned as soon as possible. Our retreat fees are different prices so please view the Retreat Schedule & Rates to determine the appropriate fee.

I hereby agree to the terms and conditions of Lehua Enterprises Cancellation policy.

_____________________________
Signed by                                 Date

Lehua Enterprises reserves the right to cancel a retreat if needed. In this situation, your entire payment will be refunded. If a retreat is cancelled, Lehua Enterprises is not responsible for substantial damages of any kind, including and without limitation to any travel,
accommodations or other expenses, or incidental damages, however caused.