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Event Registration Form
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Vipassana Hawai'i Event Registration Form

Thank you for paying your deposit to reserve your space for:

Vipassana Retreat with Mindful Movement
Dates:
Led By:
Location:
Cost:
12/28/12 to 01/04/13
Michele McDonald, Steven Smith
Khlong Long Lake, Thailand
Free


To complete the registration process, please complete this form and then click 'Submit'.
Registration Information for:

Vipassana Retreat with Mindful Movement
Dates:
Led By:
Location:
Cost:
12/28/12 to 01/04/13
Michele McDonald, Steven Smith
Khlong Long Lake, Thailand


Retreatants often have questions or concerns that they would like to discuss prior to registering for an event. We want you to feel confident and comfortable in your choice of retreat. If you would like to talk with us before you commit to registering for an event, please send us an email and we will respond promptly. You can also phone us at 808-889-0567. We are on Hawaii Standard Time which is 5-6 hours earlier than East Coast Time, depending on the time of year.

We regret that we cannot process a registration without full payment. If you are committed to attending a retreat but are unable to pay the full amount now, please contact the office and we will gladly work with you to create a payment plan.

Retreat Payment Options

A. Pay with a credit card using our secure, ecommerce provider, Paypal; complete your registration form online. You do not need a Paypal account to use their service.

B. Pay by check: print and complete your registration form and then mail it to us along with your check.

Online Registration and Payment:
Our retreat fees are based solely on the essential expenses we incur to conduct the retreat such as facility rental and food service. For those who can offer more than basic fees we thank you for your generosity. Your donation will be used to fund our retreat scholarship fund which allows people with lessor incomes to attend retreats. Part of your donation will also support Vipassana Hawaii's operating expenses.

If you would like to add a donation to your registration fee simply choose a donation level from the drop down menu below. The donation amount will be added to the basic fee and the total due will be displayed on the payment page. We are deeply grateful for your support.

1. Click on the 'Pay Now' button below; this is a Paypal link but you do not have to establish an account with them to use the service. You can simply pay with a credit card. If you already have a Paypal account you may have additional payment options available to you.
When you finish the payment process please come back to this page to complete the registration form below.

Select:
Donation:
Total: $

2. Complete the online Registration Form below. Make sure to click 'Submit' to complete the process.

3. Once we receive confirmation of your payment and your completed Registration Form we will send you an email with an attached informational packet pertaining to your retreat.

Registration and Payment by check:

1. Print out and complete the Registration Form below.

2. Mail the form along with your check to the following address:

Vipassana Hawai'i
PO Box 551681
Kapa'au HI 96755

3. Once we receive your payment and completed Registration Form we will send you an email with an attached informational packet pertaining to your retreat.

Please note our cancellation policy:

If you cancel more than 45 days prior to the retreat:
We will refund all fees less $50.00.

If you cancel 10-44 days prior to the retreat:
We will refund all fees less $100.00.

If you cancel less than 10 days prior to the event:
Last-minute cancellations are costly and sometimes mean that others cannot attend the retreat. If you withdraw less than 10 business days before the start of your retreat you will not receive a refund.

Event Registration Form