With Dr. David Frawley & Yogini Shambhavi

This is page 1 of a 3-page Registration Form.

Please ll in all pages and email to:

vedanet@aol.com

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)

Study Program is from 2015 Dec. 28 at 2:00 Pm 2016 January 1 at 6:00 Pm (5 Days)

Jan. 1, 6:00 Pm Jan 4, 2:00 Pm you will be free to tour the island.

Cost of Program -USD 2495.00 for 7 nights

Early Registration discount up to September 1, 2015 USD 2250.00

A non-refundable deposit of USD 750.00, is payable immediately to book your space.

Remaining balance is payable by November 30, 2015.

Optional Na Pali Coast Cruise: 150 USD payable at site.

PROGRAM/ RETREAT PRICE INCLUDES:

Retreat: 2015 December 28 2016 January 1 at 6:00 Pm - 10:30 Brunch, afternoon Tea and Dinner.

January 2 4, 2016 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.

Tour of the Hinduism Today Monastery on the Island of Kauai.

You are strongly advised to make your International ight 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 nancial 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%

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

Yoga Shakti Program in KauaiA M E R I C A N I N S T I T U T E O F V E D I C S T U D I E S

R E G I S T R A T I O N F O R M

PH

OT

O

2015, Dec. 28 - 4 January 2016 (7 Nights)

This is page 2 of a 3-page Registration Form and Your Photograph.

First Name (as in passport):

_______________________________________________________________________________

Last Name:

_______________________________________________________________________________

Occupation:

_______________________________________________________________________________

__

Birth Data:____Month____Day______Year______Time________ Place _________________

Address:

_______________________________________________________________________________

_______________________________________________________________________________

City: ____________State: _____________Zip: ___________Country: ____________________

Day Ph: __________________________ Eve Ph: _____________________________________

Email:

_______________________________________________________________________________

Sex: ______________Citizenship: _________________________________________________

If sharing a room, I want to share with:

_______________________________________________________________________________

Contact Person in case of emergency

_______________________________________________________________________________

_______________________________________________________________________________

Any Special Requirements

_______________________________________________________________________________

Would you like a Personal Vedic Consultation with Yogini Shambhavi? (Cost 150

USD): ___________

Have you been to Kauai before _________________________________________________

Have You Attended any of our Programs Before? Please specify

_______________________________________________________________________________

Signed and Dated ____________________________________________________________

With Dr. David Frawley & Yogini Shambhavi

Yoga Shakti Program in KauaiA M E R I C A N I N S T I T U T E O F V E D I C S T U D I E S

R E G I S T R A T I O N F O R M

2015, Dec. 28 - 4 January 2016 (7 Nights)

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

PAYMENTS

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 American Institute of Vedic Studies

at or contact us for more information.vedicinst@aol.com

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: ____________________

With Dr. David Frawley & Yogini Shambhavi

Yoga Shakti Program in KauaiA M E R I C A N I N S T I T U T E O F V E D I C S T U D I E S

R E G I S T R A T I O N F O R M

2015, Dec. 28 - 4 January 2016 (7 Nights)