You are on page 1of 5

Hawaiian Yoga Shakti Program

December 3-10, 2012, Kauai

This is page 1 of a 3-page Registration Form. Please fill in all pages and email to: 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) Program is on the Island of Kauai from Dec. 3 at 2:00 Pm Dec. 7 at 9:00 Pm Dec. 8 Dec. 10 at 2:00 Pm you will be free to tour the island. TOTAL PAYMENT Cost of Program -USD $2495.00 for 7 nights Early Registration discount up to September 1, 2012 USD 2250.00 A non-refundable deposit of $ 750.00, is payable immediately to book your space. Remaining balance is payable by November 1, 2012. We can only accommodate 15 persons. Optional Na Pali Coast Cruise: 100 USD payable in cash only. PROGRAM/ RETREAT PRICE INCLUDES: Retreat: December 3 - 7 at 9:00 Pm- morning breakfast, lunch, evening tea and dinner. Dec. 8 Dec. 10 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. 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%

Booking & Registration Form with your photograph

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: _____________________________________________________ Last Name__________________________________________________________ Occupation: _______________________________ Date:__________________________________ Address:_____________________________________________________________________ City: _________________________State: ________Zip: _______Country:_______________ Day Ph: ____________________________ Eve Ph: _________________________________ Email: ______________________________________________________________________ Date of Birth: ______________Sex _____Citizenship: _____________________________ If sharing a room, I want to share with: _________________________________________ Contact Person in case of emergency___________________________________________ ______________________________________________________________________________ Any Special Requirements ____________________________________________________ Have you been to Kauai before? _______________________________________________ Have You Attended any of our Programs Before? _________________________________

Signed and Dated____________________________________________________________

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

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 Yogini Shambhavi, or contact us for more information. This is page 3 of a 3-page Registration Form. 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: ____________________ Join Vamadeva Shastri (Dr. David Frawley) & Yogini Shambhavi on the sacred island of Kauai at the Tri Health Ayurveda Spa on the North Shore in Kilauea. Connect and Rejuvenate with Your Prana Shakti through Pranayama, Ayurveda Celebrate the Shakti force through Ritual, Mantra and Soma Heal Karmic strains with mystical lunar energies of the ancient birthing stones Tap into Shiva energies in the Rudraksha Groves at Hinduism Today Monastery Tour of the Hinduism Today Monastery: Kauai's Hindu Monastery is a lush 458-acre monastery and temple complex with a Shiva Nataraja enshrined in the main sanctum with a 700-pound, 3-foot-tall, naturally formed crystal Shivalinga ,the largest known sphatika svayambhulingam in the world and the hand-carved white granite Iraivan Temple. Na Pali Coast Boat Ride: Take a boat ride and experience the healing power of whales and dolphins. Use every precious moment to enhance your spiritual well-being....... allowing the heart to open to the flow of divine grace in this ancient land of sacred traditions........healing, energizing and rejuvenating. Remain gracious and loving; this is the land of sensitive sacred teachings. The Hawaiian language is sacred, beautiful, sweet and melodiousAloha expresses affection, love, peace, compassion, mercy and hello! alo meaning "presence", "front", "face", or "share"; and ha, meaning "breath of life" or "essence of life."Mahalo is an expression for gratitude, admiration, praise and warm regards! May the Divine Grace flow into our lives.............. Mahalo! Jai Ma Guru!