May 2017 Retreat Registration

Coming Home to Your Body, Your Life, Yourself:
On Retreat with Geneen
Geneen Roth Retreats Secure Online Registration Form
You can view this form without obligation to submit payment
I prefer to return to the Geneen Roth site now


Personal Information    * Indicates required information
First Name * 
Last Name * 
Address * 
City * 
State/Province * 
Zip/Postal Code * 
Country * 
    Phone (home)*   Phone (cell)*

Date of Birth
Email Address *

Profession

How did you hear about the retreat? *

Facebook/Twitter
Free Call
Past Retreat
       If you selected retreat - which retreat?.
Email
Workshop
       If you selected workshop - which workshop?
Book
Friend or Family Member
Therapist
Other
       If you selected other - please specify where.


May 2017 Tuition - Based on room type; includes all meals
Double Room - $2,245
Double in Cabin - $2,245
3-4 Person Room - $2,195
7 Person Room - $2,145
Dorm (14 people) - $2,095
Tent - $2,045
Van/RV - $2,045
Tuition Deposit (due upon registration): $595  
Balance of tuition due upon confirmation of accommodations.

Confirmation of Registration: You will receive email confirmation of your registration directly from Judy Ross, Manager, from Retreats@GeneenRoth.com. Your confirmation will include further information on the retreat and travel details to guide in making flight arrangements.


Registration & Cancellation Policies
Registration Payment Policy:
  • $595 down payment ($350 non-refundable/non-transferable).
  • Payment by accepted credit cards or check (made payable to "Geneen Roth & Associates Inc.").
  • Balance of retreat fees are due 12 weeks before the first day of the retreat (Feb 28, 2017). If paying by credit card, any balance due on that date will be charged to credit card on file. If paying by check, balance must be received by February 28, 2017.
Cancellation Policy:
  • Cancellations must be requested in writing to "Geneen Roth & Associates, Inc." (email, fax, or USPS).
  • Cancellations received 12 weeks or more prior to the first day of the retreat: You will receive a full refund less a $350 non-refundable/non-transferable administration fee,
  • Cancellations received between 12-8 weeks prior to the first day of the retreat: You will receive a 50% credit of the registration fee to be transferred to the next scheduled Women Food and God Retreat with space available. This credit is available only if your cancelled space is filled with another registration prior to the start of the retreat. The credit is null and void if not used at the specified retreat.
  • Cancellations received less than 8 weeks in advance of the first day of the retreat: No refunds, transfers or credits will be given for any reason.
I hereby confirm that I have read and understand the Registration & Cancellation Policies above and agree to these terms. I understand that these policies apply to this and future retreat registrations, unless revised by Geneen Roth & Associates, Inc.

Type Name & Date: 

Please note that this event is being recorded in audio and video format. The recordings may be used by Geneen Roth & Associates for the creation of future products. By purchasing, attending, and participating in this event, you acknowledge that Geneen Roth & Associates is permitted to broadcast, record, and publish your likeness, voice, and statement(s). Note: we will not use your name and will make every effort to disguise your identity in these recordings. These recordings are owned solely by Geneen Roth & Associates.

I have read and agree to the contract terms.
I prefer to return to the Geneen Roth site now