AROMANSSE WORKSHOP FORM

To register, kindly complete one form per person and mail it with your deposit to Aromansse. Box 275, 204 Riverton, MB, R0C 2R0 winnipeg@aromansse.com . Winnipeg Fax: 897-4723 (Pastry workshop make deposit to Eric Bari and send to Aromansse)

Workshop Date :____________________________

First Name: ____________________________________ Last Name: ____________________________________

Address: ____________________________________City: ____________________________________

State/Province: ____________________________________Post/Zip/Code: ____________________________________

Phone /area code: ______________________________E-mail Address: ___________________________________________

Special Dietary Requests: _________________________________________________ (only for week and weekend programs)

Special Request: ________________________________________________________(only for week and weekend programs)

The program fee includes meals, tuition and lodging.

Prices $_________ Canadian GST included

To reserve your spot we require a 20% deposit in cash, cheque or credit card. Due to the advance planning required by program participants and Aromansse, it is necessary that we administer the following credit policy.

If you cancel more than 30 days before the program date, you will receive an Aromansse credit of your deposit. If you cancel fewer than 30 days before the program date you will receive no refund or credit of fees already paid.

I understand that: (1), Aromansse declines all responsibilities for stolen personal belongings during program's activities (2) information exchanged during session(s) is educational in nature and is indented to help me become more familiar with and conscious of my own being, (3) all personal informations from other students have to remain private, (4).Furthermore, I agree to hold teachers and Aromansse Enterprises free of liability for any injuries and allergies I might suffer as a consequence of undergoing this program, (5) driving motorized vehicle is strictly prohibited during the Dying and Living Program.

Date and Signature

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