2015 Kauai Yoga Shakti Program

2015 December 28 - 04 January 2016, (7 Nights) Island of Kauai

Booking & Registration Form with your photograph

This is page 1 of a 3-page Registration Form. Please fill in all pages and email to:
vedanet@aol.com or mail to American Institute of Vedic Studies, PO Box 8357, Santa
Fe NM 87504-8357 USA
_______YES! Register me for the following: (One form per registrant, please)
Study Program is from 2015 Dec. 28 at 2:00 Pm 2016 January 1 at 6:00 Pm (5 Days)
Jan. 1, 6:00 Pm Jan 4, 2:00 Pm you will be free to tour the island.
Cost of Program -USD 2495.00 for 7 nights
Early Registration discount up to September 1, 2015 USD 2250.00
A non-refundable deposit of USD 750.00, is payable immediately to book your space.
Remaining balance is payable by November 30, 2015.
Optional Na Pali Coast Cruise: 150 USD payable at site.
PROGRAM/ RETREAT PRICE INCLUDES:
Retreat: 2015 December 28 2016 January 1 at 6:00 Pm - 10:30 Brunch, afternoon Tea
and Dinner.
January 2 4, 2016 at 2:00 Pm - only accommodation is given. Meals and sightseeing
will be at your own expense. Kitchen facilities can be used for preparing your personal
meals. Accommodation is on twin sharing basis.
Tour of the Hinduism Today Monastery on the Island of Kauai.
You are strongly advised to make your International flight bookings to the Island of
Kauai as soon as possible, as cheaper tickets tend to get sold nearer to the date of
travel. The airport to arrive at in Kauai is LIHUE. Please advise us your Flight
Information as soon as the tickets have been booked.
TRAVEL INSURANCE
Cancellation Insurance is strongly recommended as no exceptions to the cancellation
provisions can be made. Please understand that any financial loss or emergency medical
expense will be assumed by you. Please read the terms and conditions and fully
understand the cancellation penalties.
RETREAT CANCELLATIONS
The following cancellation charges as a percentage of total price apply subject to a
minimum cancellation amount of $750.00:
Before 90 days $750
6090 days or more before departure 50%
30-60 days before departure 75%
0-30 days before departure/No Shows 100%
__________I have read and understood the cancellation and travel insurance clauses

This is page 2 of a 3-page Registration Form and Your Photograph.

First Name (as in passport): ___________________________________________________
Last Name:___________________________________________________________________
Occupation: _________________________________________________________________
Birth Data:____

(Month/Day/Year) Time________

Place

Address:_____________________________________________________________________
City: _________________________State: ________Zip: _______Country:_______________
Day Ph: ____________________________ Eve Ph: _________________________________
Email: ______________________________________________________________________
Sex: ______________Citizenship: _____________________________
If sharing a room, I want to share with: _________________________________________
Contact Person in case of emergency___________________________________________
______________________________________________________________________________
Any Special Requirements ____________________________________________________
Would you like a Personal Vedic Consultation with Yogini Shambhavi? (Cost 150
USD payable at the retreat): ______
Have you been to Kauai before? _______________________________________________
Have You Attended any of our Programs Before? Please specify
_________________________________
Signed and Dated____________________________________________________________

This is page 3 of a 3-page Registration Form.

PAYMENTS

Check or Money Order Payments

Enclosed is my Check or Money Order for $
___________________________________________
Make payable and mail to:
American Institute of Vedic Studies
PO Box 8357, Santa Fe NM 87504-8357 USA
Bank Wire Transfers: Please contact us by email and we will provide you our bank
information.
Paypal Tranfers: You can transfer your payment to American Institute of Vedic Studies
at vedicinst@aol.com or contact us for more information.
CREDIT CARD PAYMENTS
BY PHONE
Please call in your credit card information to the American Institute of Vedic Studies
(505-983-9385), credit card type, number, expiration and security code. You can leave
the information on our voice mail if no one is in to answer the phone.
Also email us your billing address for the card.
BY MAIL Please verify your registration before sending in mail payments
Please furnish your credit card information and sign:
Please charge my Visa / Mastercard / American Express credit card (circle one) for the
Amount of US$____________________.
Credit Card Number:__________________________________________________________
Expiration Date:____________________Security Code:_____________________________
Billing address if different than address already given:
______________________________________________________________________________
City: ___________________State: ______________ Zip: _________ Country: ________
Signed: ___________________________________________ Date: ____________________