Register online here for the October 2007 Hawaii Spirited Work retreat. To register by mail, please print this form and send it with your check (U.S. funds only) to:

Constance Grauds, LLC
The Center for
Spirited Medicine
415-847-8192

Spirited Work Hawaii Retreat Registration Form
Name:
Street:
City:
State/province & postal code	,
Country:
Office phone:
Residence phone:
Fax number:
Email Address:
Nonrefundable deposit USD for Hawaii trip, 2006	$
Full amount USD:	$
Total amount of payment:	$
CREDIT CARD:
CARD NUMBER:
EXP DATE (MM/YY):
NAME OF CARDHOLDER: