Registration Form – Daylong, Come to Your Senses
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Transcript of Registration Form – Daylong, Come to Your Senses
RegistrationForm–Daylong,CometoYourSensesWithPeterWilliamsSaturday,March9,20198:45am–5:30pmColumbineSpiritualCenter,8900ArapahoeRd.,Boulder,COPleaseprintandfilloutthisformbeforehandandbringitwithpaymenttotheretreat.Yourcontributionamount(Suggestedis$70):Check Cash ThesuggesteddonationcoversretreatexpensesandsupportsPeter’steaching.Itisaguideline.Givenyourfinances,youmayneedtogivelessorwanttogivemore.Thankyousomuchinadvance!
Name: Phone: Address: Email(ifyoudidnotemailPeterthatyouwerecoming): Emergencycontactnameandphone(s): ParticipantWaiver:IunderstandthatIamwhollyresponsibleformyhealthandsafetyforthedurationoftheretreat,fromitsadventtoclose,andherebyholdharmlessPeterWilliams,whoistheretreatOrganizerandColumbineSpiritualCenter,whoistheOwneroftheretreatvenue,fromanyliabilitywhatsoeverresultingfrommyparticipation.IagreenottoholdtheOrganizerorOwnerresponsibleorliableintheeventofanyaccident,illness(mentalorphysical),lossofpersonalbelongings,physicalinjuryoremotionaldistressresultingfrommyparticipationinthisretreat.IunderstandthatIamfullyresponsibleforobtaininganynecessarymedicaltreatmentshouldanyaccident,illnessordiscomfortariseontheretreat.Signature: Date:
