Workshop Registration Form

Workshop runs on Friday evening from 7 to 9:30 p.m. and on Saturday and Sunday from 8 a.m. to 6 p.m.

Names

I would like to attend the workshop on:

If that one is full, my second choice would be:

Address
City
State	Zip
Phone
Email

How did you find out about our workshop and website?

While you are invited to share with the group to help build a supportive atmosphere,
you are not pressured into unwelcome self-disclosure.

Emphasis is on private sharing with your partner and confidentiality in
order to create a safe and comfortable environment.

Payment Information and Cancellation Policy

The cost of workshop per couple is $700. A deposit of $350 is required at the time of registration. The balance is due at the start of the workshop.

If the workshop is cancelled, a full refund will be made. If you cancel two weeks or more prior to the workshop, the $350 deposit is refundable less a $50 administrative charge. If you cancel less than two weeks prior to the workshop, the full $700 fee is payable; however, you may transfer this fee once to another workshop without an additional charge.

Refunds are processed following the workshop. The presenters are not responsible for pre-paid, non-refundable travel arrangements.

You can mail your check or money order to:

Betsy Bergquist
1010 Deerhaven Terrace
Stewartsville, NJ 08886

Or you can call with your credit card number:
(877) 387-8270

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